CQC report explained · a residential care home
What the CQC found at The Tobias Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks to people and the building were assessed and managed. Medicines, staffing, safeguarding, infection control and learning from incidents were also found to be managed safely.
- Effective?
- Good
- This question was not inspected during this focused visit. The report says the ratings for questions not inspected were carried over from the previous inspection.
- Caring?
- Good
- This question was not inspected during this focused visit. The report says the ratings for questions not inspected were carried over from the previous inspection.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report says the ratings for questions not inspected were carried over from the previous inspection.
- Well-led?
- Good
- Inspectors found that audits and an improvement plan were being used to monitor quality. The manager was visible and available, but the home did not yet have a registered manager.
What inspectors found, August 2022
Rated Good after a focused inspection found safe care and improved leadership, although the home did not yet have a registered manager.
Inspectors visited on 14 and 19 July 2022. They observed staff supporting people, spoke with relatives, staff and health professionals, and checked care, medicines, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found that risks in the building were being managed, medicines were handled safely, staffing met people's needs, and staff understood safeguarding procedures.
The home had improved since the previous inspection, when it was rated Requires Improvement and had breached Regulation 12. The problems had been addressed and the home was no longer in breach.
This was a focused inspection of Safe and Well-led. The other areas were not inspected during this visit, and their previous ratings were used to calculate the overall Good rating.
Safe environment
Problems with fire protection, window security, a radiator and outside flooring had been addressed. Audits also identified and helped resolve door problems promptly.
“Since the last inspection the provider had ensured risks associated with fire protection, window security, a radiator and outside floor safety were adequately addressed.” from the report
Safe medicines
Staff followed procedures for administering, recording and storing medicines. Training, competency checks and audits were in place.
“People were supported by staff who followed processes to administer, record and store medicines safely.” from the report
Support for independence
People were supported to make choices, live as independently as possible and take part in activities inside and outside the home.
“People were supported to have control of their daily lives and staff supported people to live as independently as possible.” from the report
Improved management
Management and audit systems had improved since the previous inspection. A service improvement plan was being reviewed by the provider.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
No registered manager yet
minorThere was no registered manager in post at the inspection. A new manager was in place and was applying to register with the CQC.
“At the time of our inspection the service did not have a registered manager.” from the report
Supervision system still being introduced
minorThe new manager was implementing staff supervision. Families may want to check whether this system is now fully established.
“The manager and staff told us they understood their roles and responsibilities and there was a clear management structure in place.” from the report
- 01Has the manager now completed registration with the CQC?
- 02Is the staff supervision system now fully in place, and how often do staff receive supervision?
- 03How do you make sure agency staff understand each person's current risks and care needs?
- 04How are changes to building safety risks recorded and checked after repairs?
- 05How will you maintain the improvements made since the previous inspection?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection and were not assessed during this visit. This explanation was written from the published report of 17 August 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, August 2019
Requires Improvement; The Tobias Centre provided kind, personalised care, but safety risks and weak leadership systems remained.
Inspectors visited on 28 June and 2 July 2019. They observed the six people living there, spoke with managers, received feedback from four relatives and six staff, and checked care, medicines, staff and management records.
People were treated with dignity and respect. Staff supported choice, independence, communication, healthcare and activities in the community. Medicines had improved since the last inspection, and the home was rated Good for effective, caring and responsive care.
Inspectors found safety risks in the building. These included fire safety actions not being followed up, unrestricted sash windows, an uncovered radiator and weaknesses in how risks were communicated. The home was also not well-led, with concerns about monitoring, staff support and morale.
The overall rating was Requires Improvement. This was the third consecutive inspection with this rating. The provider breached Regulation 12 on safe care and treatment and was required to make improvements.
Choice and independence
People were supported to make choices, build skills and become more independent. They could access the community and choose activities that interested them.
“People living at The Tobias Centre had their need for choice and control, independence and inclusion respected.” from the report
Kind and respectful care
Staff treated people with dignity and knew how to anticipate their needs and reduce distress.
“We observed respectful and caring interactions between staff and people.” from the report
Personalised support
Care plans reflected individual routines, preferences and communication methods. Relatives were involved in care planning and kept updated.
“There was a strong person-centred culture at the service and people received individualised care.” from the report
Communication support
The home used methods suited to each person, including British Sign Language, Makaton and photographs.
“The service ensured people could communicate in line with their assessed needs.” from the report
Improved medicines management
Medicines were ordered, stored, administered and recorded safely. This was an improvement since the previous inspection, which had found a medicines breach.
“People had their medicines given as prescribed and these were recorded clearly and accurately.” from the report
Safety risks in the building
seriousFire safety actions had not been followed up. Unrestricted windows created a risk of falls, and an uncovered radiator created a risk of burns.
“We found concerns around the safety of the environment in respect of fire safety, preventing falls from height and ensuring people were no burnt by uncovered radiators.” from the report
Weak safety monitoring
seriousThe home's audits did not clearly show what action would be taken when problems were found. This meant important risks were not dealt with quickly enough.
“The governance and auditing systems had not been effective in identifying these risks to people” from the report
Staff morale and support
needs fixingAll staff who gave feedback said they did not feel supported or valued. They reported cancelled meetings, slow responses and low morale.
“They told us their morale was low and were worried about the impact on people who used the service if it continued.” from the report
Staff turnover and cover
needs fixingStaff and a relative raised concerns about high staff turnover. Staff from other homes were used to fill rota gaps, and their skills and knowledge needed review.
“Staff and a family member shared some concerns with us about staffing. They told us there had been a high staff turnover.” from the report
- 01Have all the fire safety actions identified in January 2019 now been completed, and how are they checked?
- 02How are windows, radiators and other possible environmental hazards inspected and kept safe?
- 03What has been done to improve staff morale, communication and the regularity of staff meetings?
- 04How do you make sure staff from other homes have the right skills and knowledge before supporting people here?
- 05What changes have been made to the electronic audit system so that overdue safety actions are flagged and completed?
This was a planned inspection covering all five key questions, including both the care provided and the premises, following the previous Requires Improvement rating. This explanation was written from the published report of 14 August 2019 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 The Tobias Centre
5 rated inspections over 6 years: the service has held its Good rating throughout.
- August 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 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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