CQC report explained · a residential care home
What the CQC found at Tigh Fruin
Rated Outstanding: inspectors found the home performing exceptionally well.
What inspectors found, December 2021
Rated Requires Improvement; inspectors found kind care and safe medicines, but staffing, communication and care planning were not consistently good.
Inspectors visited unannounced on 24 and 26 August 2021. They observed care, spoke with relatives and staff, and checked care records, medicines, training and management systems.
There were not always enough staff to keep people safe or provide the support set out in their assessments. Inspectors also found that some safeguarding concerns had not been reported in the past. People were usually given medicines safely, their health needs were assessed, and the home was clean.
People were treated with warmth, dignity and respect, but were not always involved in care reviews or supported consistently with their communication needs. Relatives also reported difficulties getting updates and raising concerns. The overall rating was Requires Improvement, falling from Outstanding at the previous inspection.
Safe medicines
Inspectors found that medicines were generally recorded, given and disposed of safely. Staff were trained and had their competence checked.
“The system for managing medicines ensured people were given the right dose at the right time.” from the report
Kind and respectful care
People appeared comfortable with staff. Care was provided with dignity, privacy and respect for independence.
“Care and support was offered by staff with warmth and good humour to everyone we saw.” from the report
Food and health support
People were supported with balanced food and drink, including meals prepared to meet professional guidance. Staff contacted health professionals when needed.
“People were supported to eat and drink well, and to have a balanced diet.” from the report
Learning from incidents
The provider investigated incidents, identified triggers and changed care plans and support to reduce the risk of repeat incidents.
“People's care plans and the support they received was reviewed and changed. This reduced the risk of further incidents.” from the report
Staff shortages
seriousThere were times when people did not receive the staff support they had been assessed as needing. This created a safety risk and was a breach of Regulation 18.
“There were not always enough staff to keep people safe or to provide them with the individual support they were assessed as needing.” from the report
Past safeguarding failures
seriousBefore April 2021, some safeguarding concerns were not reported by staff. The provider acted with the local authority once the concerns were identified.
“Prior to April 2021, there were a number of safeguarding concerns which staff had not reported.” from the report
Communication and involvement
needs fixingPeople were not always involved in care reviews, especially when they had difficulty communicating. Staff did not always use preferred communication methods consistently.
“People were not always involved in reviews of their care, particularly where they were less able to communicate their needs.” from the report
End of life planning
needs fixingNo one was receiving end of life care during the inspection, but the home had not supported people and relatives to discuss future wishes if they wanted to.
“There was no evidence that staff were trained or supported to discuss end of life care planning with people and their relatives.” from the report
Family communication
needs fixingRelatives said it was difficult to get visiting information and updates. Some were not confident that concerns would be passed to the right person and dealt with.
“Relatives were disappointed with communication during the pandemic, and felt that getting information about visiting and updates on their family members was difficult.” from the report
- 01How many staff are planned for each shift, and how often are shifts currently below that level?
- 02How do agency and new staff learn each person's communication methods, triggers and support plans?
- 03How are people who communicate without speech involved in care reviews and supported to make complaints?
- 04What action has been taken since the inspection to prevent safeguarding incidents and ensure concerns are reported promptly?
- 05How will the home support people and relatives to discuss and record end of life wishes?
This was an unannounced comprehensive inspection covering all five key questions, including infection prevention and control; all five ratings were reassessed and had fallen from the previous inspection. This explanation was written from the published report of 2 December 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.
What inspectors found, April 2020
Rated Outstanding; inspectors found exceptionally effective and responsive care, with safe, kind and well-led support.
Inspectors made an unannounced visit on 18 February 2020. They observed care, spoke with staff and managers, reviewed care, medicine, recruitment and management records, and contacted professionals and family members afterwards.
The home supported six people with learning disabilities and autism. Inspectors found that people were treated with dignity, involved in decisions and supported to build skills, relationships and independence. Staff used personalised communication, including pictures, objects of reference and Makaton sign language.
The overall rating was Outstanding. Safe, caring and well-led were rated Good. Effective and responsive were rated Outstanding. Since the previous inspection, the overall rating improved from Good, effective improved from Requires Improvement, and responsive improved from Good.
Personalised communication
The home used several communication methods and specialist equipment to help people understand information and express choices.
“Makaton sign language, pictures and objects of reference were also used.” from the report
Skilled staff
Staff received detailed induction, bespoke training and ongoing support. The training helped staff understand the reasons behind people's behaviour and reduced the need for restraint.
“Since the introduction of this training, the need for restraint had been reduced and people's life experience had improved.” from the report
Independence and activities
People were supported to develop skills through personal goals, activities, education, work-related opportunities and community involvement.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Family relationships
The home involved families in care planning and communication, and worked to maintain or rebuild family relationships.
“There was a commitment to build and maintain relationships with the people's family.” from the report
Health support
Staff worked with health professionals, monitored health conditions and used evidence from incidents and symptoms to improve support and treatment.
“Staff and health care teams had worked collaboratively to ensure the best outcome for people's health care.” from the report
An incident was not recorded
needs fixingInspectors found that a fall had not been recorded. The support plan was updated and staff were reminded about the importance of recording incidents.
“This referred to an incident where a person had fallen and it had not been recorded.” from the report
Some labels were difficult to read
minorA quality check identified that some bottles needed replacing because their labels had become difficult to read. This action was being followed up.
“We saw an action which related to the replacement of bottles as the labels had become difficult to read.” from the report
- 01How would you support my relative to communicate choices, preferences and concerns?
- 02What training would the staff supporting my relative have for their specific needs, including autism or behaviour that may place them at risk?
- 03How would you support my relative to build independence through activities, education, work or community opportunities?
- 04How would you involve our family in care planning, health decisions and regular updates?
- 05How do you record and review falls, seizures and other incidents, and what changes would follow if one occurred?
This was an unannounced planned inspection covering all five CQC questions and both the premises and the care provided. This explanation was written from the published report of 10 April 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.
Every inspection of Tigh Fruin
4 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- December 2021Requires improvementcurrent ratingdown from OutstandingSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2020Outstandingup from GoodSafe: GoodEffective: OutstandingCaring: GoodResponsive: OutstandingWell-led: Good
- September 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2015
Registered with the Care Quality Commission on 6 August 2015.
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 £980 to £1,260 a week. 63 can care for a couple. 10 years' experience on average.
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