CQC report explained · a residential care home
What the CQC found at The Trio House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable recruitment checks, improved fire safety and safe medicines procedures. Staff understood how to identify and report possible abuse.
- Effective?
- Good
- Staff had induction, training and regular support. People were supported with food, health appointments and decisions about their care, although inspectors asked for clearer information about one person's dietary and health needs.
- Caring?
- Good
- Inspectors found kind and respectful relationships. Staff involved relatives, supported people's choices and promoted privacy, dignity and independence.
- Responsive?
- Good
- Care plans reflected people's individual preferences and communication needs. People were supported with activities, relationships, complaints and planning for end-of-life care.
- Well-led?
- Requires improvement
- The provider had improved its audit and checking systems, but these had not identified unclear or incomplete care records. The provider needed to show that improvements could be sustained.
What inspectors found, January 2020
Rated Good overall, but inspectors found the home needed to improve its quality checks and care records.
The inspection took place over 29 November and 4 December 2019. One inspector spoke with the provider, managers and staff, observed care, checked records and premises, and contacted relatives and health and social care professionals.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines systems, kind and respectful care, personalised care plans, useful activities and good support with health needs.
Well-led was rated Requires Improvement. The provider had improved its audits and checks, but some care records were incomplete or unclear. The provider also needed to show that its improvements would continue over time. The previous overall rating was Requires improvement, so the overall rating had improved.
Improved safety
Fire safety had been improved, including new detection and emergency lighting systems, fire doors and safety signs. Staff also understood safeguarding procedures.
“People were supported by staff who understood how to identify and report potential abuse.” from the report
Personalised care
Care plans included people's likes, dislikes and preferences. Staff said they read and followed the plans.
“People's care plans were individual to them, kept under regular review and included information about their likes, dislikes and preferences to encourage a person-centred approach.” from the report
Kind and respectful staff
Relatives and inspectors described positive relationships. Staff supported people's dignity, privacy, choices and independence.
“One relative told us, "I have never seen staff show anything other than respect for the people who live at the home.” from the report
Activities and community life
People were supported to take part in activities inside and outside the home, including trips, swimming, bowling, baking and arts and crafts.
“People had support from staff to participate in activities, both within and outside of the home, which they found interesting and enjoyable.” from the report
Care records were not always clear
needs fixingSome records did not clearly describe one person's dietary needs or fully reflect specialist advice. Records about one person's long-term health condition were also incomplete.
“The guidance recorded in relation to one person's dietary needs was not sufficiently clear and did not fully reflect the advice provided by the speech and language therapist.” from the report
Improvements needed to last
needs fixingThe provider had introduced better audits and checks, but CQC wanted evidence that these improvements were fully embedded and could be maintained.
“However, the provider needed to demonstrate these improvements could be sustained over to time to assure us they were fully embedded in the service.” from the report
- 01How have you corrected the unclear dietary guidance identified in the inspection report?
- 02How do you now record and review long-term health conditions?
- 03How do your monthly audits check that care records contain complete and accurate information?
- 04What evidence can you show that the improvements to quality checks and fire safety have been sustained?
- 05How are relatives involved when care plans or health needs change?
This was a planned inspection following the previous Requires improvement rating and covered the home, care provided and all five CQC questions. This explanation was written from the published report of 7 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, August 2019
The Trio House was rated Requires Improvement; inspectors found serious safety and management failures, with Well-led rated Inadequate.
One inspector visited on 11 and 18 April 2019. The first visit was unannounced. Inspectors observed care, spoke with relatives, staff and health and social care professionals, and checked care, medicines, recruitment, safety and quality records.
The home was not always safe. Fire arrangements were inadequate, including insufficient fire detection, no emergency lighting, missing fire doors and incomplete evacuation plans. Some individual risks, equipment and health information were also not managed well. Safeguarding concerns had not always been reported to the right organisations.
There were positive parts. Staff were described as kind and attentive. People had individual care plans, support with food and drink, activities and communication. The home was clean and comfortable, and staff supported people's rights to make decisions.
The overall rating was Requires Improvement. Safe, Effective, Caring and Responsive were all Requires Improvement, while Well-led was Inadequate. The report says this was the third successive inspection where regulations were not met. The service had previously been placed in special measures after the 2017 inspection.
Kind day-to-day care
Inspectors saw staff providing patient, attentive and caring support. Relatives also spoke positively about how people were treated.
“Management and staff provided people's day-to-day care and support in a patient, attentive and caring manner.” from the report
Communication and choice
Staff adapted how they communicated and helped people make everyday choices about activities, food and how they spent their time.
“Staff promoted effective communication with people.” from the report
Food and drink support
People were supported to choose what they ate and drank. Dietary advice was followed for one person who needed modified food and thickened fluids.
“People had support to maintain a balanced diet and to make choices about what they ate and drank.” from the report
Clean and comfortable home
The home was clean, hygienic and fresh-smelling. Inspectors found it comfortable, homely and suitable for visitors, activities and private time.
“The home provided a comfortable, 'homely' and well-furnished environment for the people who lived there.” from the report
Respect for decision-making
Staff supported everyday choices, and records showed mental capacity assessments and best-interest decisions for significant matters.
“The provider and staff team understood and promoted people's rights under the Mental Capacity Act 2005.” from the report
Fire safety
seriousThe home did not have adequate fire detection, emergency lighting, fire doors, signs or evacuation plans. Inspectors contacted the local fire and rescue service after the visit.
“The provider had not taken appropriate steps to reduce the risk to people from fire at the premises.” from the report
Risk management and equipment
seriousSome people's risks were not fully assessed or clearly recorded. Inspectors also saw an unsuitable chair and pillows being used when safer equipment was needed.
“The provider's procedures for assessing, reviewing and managing the risks to people's health, safety and welfare were not sufficiently robust or effective.” from the report
Safeguarding reporting
seriousAllegations of abuse reported to the provider had not been passed to the local safeguarding adults team or CQC for external investigation.
“The provider had not always reported allegations of abuse in line with local safeguarding procedures, in order that these could be investigated externally.” from the report
Health care planning
needs fixingTwo people had epilepsy, but comprehensive epilepsy care plans had not been developed. One person's seizures were not being recorded appropriately.
“The provider had not developed comprehensive epilepsy care plans for these individuals, and one person's seizures were not being appropriately recorded.” from the report
Activities had lapsed
minorPeople had access to activities, but one relative wanted more support with socialising and exercise. The provider acknowledged that varied activities had lapsed in recent months.
“The provider acknowledged people's access to varied and meaningful social and recreational activities had lapsed in recent months.” from the report
- 01What actions have been completed to improve fire detection, emergency lighting, fire doors, fire signs and evacuation plans?
- 02What are the current risk assessments and safe equipment arrangements for each person's mobility and support needs?
- 03How are epilepsy care plans and seizure records now kept up to date?
- 04How are safeguarding allegations reported to the local safeguarding adults team and CQC?
- 05What evidence can you show that quality checks now identify and correct safety and care problems?
This was an inspection of the care provided and the premises, covering all five CQC questions and reviewing records for all three people living at the home. This explanation was written from the published report of 30 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 Trio House
5 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 21 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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11 live-in carers within about an hour of Herefordshire, County of
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 £960 to £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.