CQC report explained · a residential care home
What the CQC found at Tinkers Hatch
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risks were generally managed because staff knew people well, and medicines were managed safely. However, inspectors found problems with window restrictors, an uncovered fuse box, an unclear mealtime observation plan, staffing pressures, mask use and cleanliness.
- Effective?
- Requires improvement
- The home supported people's health needs and staff received training and supervision. However, mental capacity assessments and best-interest decisions were missing or incomplete for some restrictions and care arrangements, which breached the legal requirements.
- Caring?
- Good
- No separate rating was given for Caring in this report. Inspectors saw positive relationships and said staff supported people with kindness and care.
- Responsive?
- Requires improvement
- People had access to activities, trips and personalised communication. However, the home had not developed individual goals or activity care plans, did not always promote independence and skills, and had no recorded end-of-life wishes for people.
- Well-led?
- Requires improvement
- The manager was aware of many improvements needed and had started some work. However, records and audits were incomplete, quality systems were not reliable, and inspectors found a negative staff culture that had not been addressed quickly enough.
What inspectors found, August 2022
Tinkers Hatch is rated Requires Improvement; inspectors found kind, knowledgeable staff, but problems with consent, records, activities and staff culture.
This was an unannounced focused inspection carried out on 31 May, 6 June and 13 June 2022. Inspectors spoke with eight people, 11 relatives, 18 staff and seven health and social care professionals. They also observed care and checked care plans, medicines, staff files and management records.
The home was usually safe in practice, and staff knew people well. However, some environmental risks, staffing pressures, infection control practices and care records needed improvement. Inspectors also found that the home was not always following the legal rules about consent and mental capacity.
People were supported with kindness and many enjoyed activities, trips and celebrations. But activities were sometimes cancelled because of staff absence, and people were not always helped to build independence or develop daily living skills. The overall rating remains Requires Improvement, and this is the fourth consecutive inspection with that rating.
Staff knew people well
Staff understood people's communication methods, needs and preferences. Inspectors and health professionals found that staff responded to changes in people's health.
“Staff knew people really well and understood how to communicate with them in a meaningful way.” from the report
Kind relationships
People appeared comfortable with staff and families spoke positively about the care. Inspectors saw people approaching staff freely and engaging with them.
“Despite these concerns people demonstrated positive relationships with staff.” from the report
Health support
The home worked with GPs and other professionals to respond to health needs and arrange suitable equipment.
“Healthcare professionals told us staff were proactive in identifying concerns.” from the report
Activities and trips
Some people enjoyed regular activities and outings, including trips to local zoos and a farm visit. People were involved in discussing activities.
“Regular trips out were arranged.” from the report
Medicines managed safely
Staff were trained and assessed before giving medicines. The home had systems for ordering, storing, giving and disposing of medicines.
“Medicines were managed safely.” from the report
Care planning and records
seriousCare plans were sometimes conflicting or lacked important information. Daily records, oral care records and bowel charts were not always completed properly. This was part of the breach of Regulation 17.
“Daily records were not well completed, this included oral care and bowel charts.” from the report
Independence and meaningful activity
seriousPeople were not always supported to develop daily living skills, set personal goals or take part in meaningful activities. This breached Regulation 9.
“People did not always receive support that promoted their independence, skills and social needs.” from the report
Staff culture
seriousMost staff spoken with described divisions, bullying concerns and information being withheld. Inspectors said insufficient action had been taken to improve the culture, breaching Regulation 17.
“There was a negative staff culture at Tinkers Hatch.” from the report
Staffing and infection control
needs fixingThere were enough staff to keep people safe, but staff absences reduced activities and affected quality. Inspectors also saw masks worn incorrectly and found mould and rust in bathrooms.
“On the first day of the inspection there were staff absences in the day centre.” from the report
End-of-life planning
needs fixingThere was no information about some people's wishes for end-of-life care, including people who had lived at the home for many years and had become frailer.
“There was no information about people's wishes for their end of life care.” from the report
- 01What has changed since the inspection to make sure capacity assessments and best-interest decisions are completed before restrictions are used?
- 02How are you checking that care plans, bowel charts, oral care records and daily notes are complete and accurate?
- 03How will you make sure staff absences do not leave people without planned activities or meaningful alternatives?
- 04What action has been taken to address the staff culture, including the concerns about bullying and information being withheld?
- 05How are people being supported to set personal goals and develop daily living skills, including managing parts of their own medicines where appropriate?
This was a focused inspection of the Right Support, Right Care, Right Culture principles, with Safe, Effective, Responsive and Well-led assessed; Caring was not separately rated in the report. This explanation was written from the published report of 3 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, February 2021
Inspected but not rated; inspectors were assured about infection control during the COVID-19 outbreak.
This was a targeted inspection of infection prevention and control during a coronavirus outbreak. The report says the inspection was announced and looked at whether the home was following infection control requirements.
Inspectors found the home clean and tidy, with regular cleaning of high-touch areas. Staff had enough personal protective equipment, received risk assessments, and people and staff were tested regularly.
People who were unwell, self-isolating or had tested positive were cared for in their rooms where possible. The main house and cottage were kept separate, with different staff teams. At the time of the visit, the isolation period had ended and people could move around their own areas.
The service was inspected but not rated. This means the report does not give a Good, Requires Improvement or Inadequate rating from this visit. The report says resources were signposted to help the home develop its approach.
Clean environment
The home was clean and tidy, with regular cleaning during the day, including high-touch areas.
“The home was clean and tidy. There was regular cleaning throughout the day, and this included high-touch areas.” from the report
PPE and testing
Staff had adequate PPE and were seen wearing it. People and staff received regular testing in line with government guidance.
“Staff were provided with adequate supplies of personal protective equipment (PPE) and were seen to be wearing this.” from the report
Managing infection risks
The home used separate areas and staff teams, and cared for people in their rooms where possible during the outbreak.
“During the outbreak people from the main house and cottage have been kept separate. There were designated staff teams for each area.” from the report
Further development suggested
minorInspectors signposted the home to resources to develop its infection prevention and control approach. The report does not explain what specific change was needed.
“We have also signposted the provider to resources to develop their approach.” from the report
- 01What resources were you signposted to, and what changes did you make as a result?
- 02How do you keep the main house and cottage separate if there is another infection outbreak?
- 03How often are people and staff tested, and what happens when someone tests positive or becomes unwell?
- 04What infection control arrangements are currently in place for visitors and new admissions?
This was a targeted inspection of infection prevention and control during a coronavirus outbreak; it was not a full inspection and the service was inspected but not rated. This explanation was written from the published report of 23 February 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.
Every inspection of Tinkers Hatch
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- January 2020Requires improvementstayed Requires improvementSafe: GoodEffective: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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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19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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.