CQC report explained · a residential care home
What the CQC found at Timaru
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- The home had improved its risk management, infection control, staffing and safeguarding arrangements. However, medicines records and checks were not yet consistently reliable, and the report said there was an increased risk that people could be harmed.
- Effective?
- Inadequate
- This question was not covered by this focused inspection. Its previous rating was carried forward, but that rating is not stated in this report.
- Caring?
- Requires improvement
- This question was not covered by this focused inspection. Inspectors nevertheless reported that care was not always person-centred and did not consistently promote dignity, privacy and human rights.
- Responsive?
- Requires improvement
- This question was not covered by this focused inspection. Inspectors saw more meaningful activities and community involvement, but also noted that choice, control and independence were not consistently maximised.
- Well-led?
- Requires improvement
- Management and governance had improved, and leaders understood their roles. However, the report said systems still needed time to become sustained and embedded in everyday practice.
What inspectors found, May 2023
Timaru was rated Requires Improvement; inspectors found progress since an Inadequate rating, but medicines, staffing and person-centred care still needed attention.
This was a focused inspection on 18 April 2023. One inspector spoke with managers, observed staff and residents, reviewed care and infection control records, checked staff files, and gathered feedback from a relative and support workers.
The overall rating improved from Inadequate to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The home had improved its training, recruitment, infection control and management systems, but inspectors said these improvements needed to be sustained.
The inspection found that care was not always person-centred and did not consistently protect people's choice, dignity, privacy and independence. Medicines records and checks also needed further improvement, and the home had staff vacancies and no registered manager at the time.
Improved staff training
Staff had received training in positive behavioural support, safeguarding and other areas. Competency checks had also been carried out for medicine administration.
“Staff received appropriate training, supervision, and competency assessment.” from the report
Better infection control
The home was clean and well maintained. Inspectors were assured that infection risks, visitors, equipment and possible outbreaks were being managed.
“We were assured that the provider was using PPE effectively and safely.” from the report
More meaningful activities
People were seen taking part in activities and some were going into the community. Feedback also described more choice in daily routines and practical tasks.
“The culture of the service had improved, and people were engaged in more meaningful activities.” from the report
Improved management
The home had made progress with governance and was open about the work still needed. Managers and staff were clearer about their responsibilities.
“During our inspection we spoke with deputy manager, the director of quality and governance and the regional manager. Each of them were clear about their roles and responsibilities.” from the report
Medicine checks
seriousBowel records were not always reviewed during medicine rounds to check whether as-required medicine was needed. Further progress was required in medicine management.
“Bowel records are not being reviewed as part of medication administration.” from the report
Staff vacancies and driving
needs fixingThe home had nine vacancies. A relative also said a driver was not available on some days, which could limit daily drives and community access.
“The provider had 9 staff vacancies and was actively recruiting.” from the report
Care was not consistently person-centred
needs fixingThe model of care and the environment did not always maximise choice, control and independence. Inspectors also found that dignity, privacy and human rights were not always promoted.
“Right care: Whilst improvements had been made, care was not consistently person-centred and at times, and on occasions, failed to promote people's dignity, privacy, and human rights.” from the report
No registered manager
needs fixingThere was no manager registered with the CQC during the inspection. The provider was recruiting one.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01How do you now check bowel records during medicine rounds, including whether as-required medicine is needed?
- 02How many staff vacancies remain, and how do you make sure there are enough permanent staff for one-to-one support?
- 03Is a registered manager now in post, and how are governance checks being kept effective?
- 04How do you make sure each person has consistent choice, privacy, dignity and control over their daily routine?
- 05How often are drivers available for community activities and daily drives?
This was a focused inspection of Safe and Well-led; the other key-question ratings were carried forward from the previous inspection. This explanation was written from the published report of 26 May 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, April 2023
Rated Inadequate and placed in special measures; inspectors found serious problems with staff training, safety, activities and leadership.
The inspection took place on 29 September and 6 October 2022. One inspector and a specialist adviser spoke with staff and managers, observed care, and checked care, medicine, staffing and management records.
The home was not able to show that people were consistently safe or receiving effective, person-centred care. Most support workers were from agencies, and staff on shift had not completed training for supporting distress and behaviour that could harm people.
Inspectors also found problems with building repairs, infection control, staff supervision, activities, dignity, complaints and quality checks. Four legal regulations were breached.
The overall rating is Inadequate. Safe, Effective and Well-led were rated Inadequate. Caring and Responsive were rated Requires Improvement. The home was placed in special measures and the CQC said it would return to check for significant improvement.
Care plans
Care plans contained information about people's risks, needs, preferences and ways to support them when distressed.
“Care plans were detailed and provided strategies to support people when they were expressing feelings or an emotional reaction.” from the report
Medicines information
The home had person-centred instructions for medicines given when needed, and staff had information about changes to medicines.
“For medicines to be administered 'when required' (PRN), person centred protocols were in place.” from the report
Recruitment checks
Inspectors found that recruitment records contained the required information and that DBS checks were completed before staff started work.
“Safe recruitment processes were in place. Staff files contained all of the information required under Schedule 3” from the report
Healthcare links
Records showed that people were referred to healthcare professionals when needed, and staff supported people to access COVID vaccinations.
“Documents recorded occasions where people were referred to healthcare professionals such as speech and language team, GP's and the dentist.” from the report
Staff training and safety
seriousNo support workers on shift had completed the required PROACT-SCIPr-UK training, despite people sometimes showing distress or behaviours that could cause harm.
“none of the support workers who were on shift had completed training in PROACT-SCIPr-UK.” from the report
Building and infection risks
seriousInspectors found an unlocked COSHH cabinet, a ripped mattress, mould, damaged flooring and other maintenance concerns. These problems could put people at risk of harm or infection.
“One person's mattress was ripped with its foam exposed. Another person had mould in their bathroom and a broken radiator cover.” from the report
Staffing and continuity
seriousSix of the eight support workers on shift were agency staff. High turnover meant the home could not be sure that staff knew people's needs and risks.
“Due to the significant turnover in staffing we could not be assured people consistently received care and support from staff who knew their needs” from the report
Dignity and engagement
needs fixingStaff did not always engage meaningfully with people or know their interests. Inspectors saw staff looking at mobile phones instead of spending time with people.
“On numerous occasions during our inspection we found staff failing to engage with people whilst sitting on chairs looking at their mobile phones.” from the report
Activities and community access
needs fixingPeople were not consistently supported to take part in their chosen activities. Staff shortages, a lack of trained staff and unreliable cars limited trips out.
“Despite care records highlighting people's preferred activities, daily records failed to demonstrate people were regularly supported to access their chosen interests and hobbies.” from the report
Weak leadership checks
seriousThe provider's audits and governance systems did not identify or respond effectively to concerns about care, staffing, safeguarding, risk and maintenance.
“The provider's governance systems were not effective in driving improvement which placed people at significant risk of harm.” from the report
- 01How many permanent staff now work at the home, and what training have all staff completed to support distress and behaviour that may harm people?
- 02What repairs and infection control improvements have been completed, including the mattress, mould, flooring, radiator cover and COSHH cabinet?
- 03How will you make sure each person regularly takes part in their chosen activities and visits the local community?
- 04How are complaints now explained and recorded in a way that each person can understand?
- 05Who is currently responsible for the home, and how are audits checking staffing, safeguarding, care plans, incidents and risks?
This inspection assessed all five key questions and looked at both the premises and the care provided, including infection prevention and control; the previous ratings were from 2017. This explanation was written from the published report of 6 April 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.
Every inspection of Timaru
4 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2023Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 22 February 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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26 live-in carers within about an hour of Hampshire
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 £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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.