CQC report explained · a residential care home
What the CQC found at Tiltwood
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks and incidents were being assessed and reviewed more effectively, although staffing was not always deployed evenly across the suites.
- Effective?
- Requires improvement
- The environment did not always support people living with dementia or visual impairments. Staff skills in managing complex needs, supporting people who declined care, and applying mental capacity principles were variable.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Good
- The management team had made significant progress through an improvement plan. Leaders promoted openness, listened to feedback and worked constructively with health professionals.
What inspectors found, August 2023
Rated Good overall; the home was safe and well-led, but effective care requires improvement.
This was an unannounced focused inspection. Inspectors visited on 27 June 2023 and reviewed information, care records, medicines records, staff recruitment and training records, incidents and audits. They spoke with 10 people, two relatives, 18 staff and two visiting professionals.
The home was rated Good for safety and leadership. Inspectors found systems to protect people from abuse and avoidable harm. Risks and incidents were being managed better, medicines were handled safely, and staff recruitment checks were completed.
Effective care was rated Requires Improvement. The layout and decoration did not always help people living with dementia or visual difficulties. Staff confidence in supporting complex needs was variable, and some care was not always delivered sensitively. The home had already started an improvement plan, and inspectors found no evidence that people were at continued risk of harm from the concerns that prompted the inspection.
Better risk management
The home had improved how it reviewed incidents and accidents. Staff were given information about new risks at handovers and meetings.
“Appropriate analysis of incidents and accidents was now being completed to identify any themes and trends.” from the report
Safe recruitment
The home completed the required recruitment checks before staff started work.
“Staff were recruited safely, and appropriate Disclosure and Barring Service (DBS) checks, and other relevant recruitment checks were completed.” from the report
Medicines handled safely
Only trained and checked staff administered medicines. Records were completed after medicines were given.
“Staff took their time to give people their medicines, checking the medicine against the records before administering it.” from the report
Open leadership
The management team encouraged staff and families to raise concerns. Feedback was used to make changes.
“At both provider and management levels, an open and inclusive approach was promoted which ensured people were treated with respect and honesty.” from the report
Dementia-friendly environment
needs fixingThe layout, colours and doors did not always make it easy for people with dementia or visual impairments to find their way. Redecoration and furniture replacement were in progress.
“the overall design and decoration at Tiltwood did not facilitate easy navigation for people living with cognitive or visual impairments.” from the report
Variable support skills
needs fixingSome staff did not have enough confidence or skill when supporting complex needs. People who initially declined personal care were not always supported effectively or sensitively.
“As such, some people who lacked capacity to consent to personal care were not always sensitively supported to receive support that was in their best interests.” from the report
Dining experience
needs fixingPeople's food, drink and dietary needs were met, but mealtimes were often focused on serving and clearing rather than creating a social experience. Further training was being introduced.
“Our observation of the lunchtime meal highlighted that whilst people's dietary and support needs were met, the dining experience across most suites was task led.” from the report
- 01What changes have been completed to make the layout and decoration easier for people living with dementia or visual impairments to navigate?
- 02How do you check that staff can support people who initially refuse personal care in a sensitive way?
- 03What training and supervision are staff receiving to manage complex needs and apply mental capacity principles?
- 04What changes have been made to make mealtimes more social and less task led?
- 05How are staff deployed at busy times so that suites with people who have higher needs have enough support?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 19 August 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, March 2022
Tiltwood was inspected but not rated; inspectors found strong infection control and measures to manage staffing pressures.
This was a targeted, announced inspection on 28 February 2022. It looked at infection prevention and control, visiting arrangements and whether COVID-19-related staffing pressures affected people. It did not assess all areas of the service.
Inspectors found the home was clean and hygienic. Staff used suitable protective equipment, high-touch areas were cleaned regularly and infection control audits were completed. Testing, vaccination and self-isolation arrangements followed the guidance described in the report.
The home had risk assessments and had changed its staffing model to reduce cross-infection and provide consistent support. Inspectors were assured about the infection control arrangements, but the service was not given a rating.
Clean environment
The home was clean and hygienic, with domestic staff cleaning high-touch areas during each shift.
“The service was clean and hygienic.” from the report
Infection control
Inspectors were assured that the home used PPE safely, arranged testing and managed possible outbreaks. The infection control policy was up to date.
“We were assured that the provider was using PPE effectively and safely.” from the report
Contact with loved ones
The registered manager used a person-centred approach to help people keep suitable contact with their relatives during the pandemic.
“The registered manager had adopted a person-centred approach to supporting people to maintain appropriate contact with their loved ones throughout the pandemic.” from the report
Inspectors raised no specific concerns in this report.
- 01How are staffing pressures affecting people's care and routines now?
- 02How are visits arranged, and what happens if infection risks change?
- 03How often are high-touch areas cleaned, and how are cleaning checks recorded?
- 04How are testing and vaccination decisions made for people who cannot consent?
- 05How often can people access the GP and other healthcare professionals when they need them?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not assess the other key questions. This explanation was written from the published report of 16 March 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.
Every inspection of Tiltwood
4 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- August 2023Goodcurrent ratingSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2022Inspected but not ratedSafe: Inspected but not rated
- June 2018Goodup from Requires improvementSafe: GoodEffective: Requires improvementWell-led: Good
- April 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- February 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 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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77 live-in carers within about an hour of Surrey
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Most charge £980 to £1,250 a week. 66 can care for a couple. 11 years' experience on average.
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