CQC report explained · a nursing home
What the CQC found at Toller Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found suitable staffing, risk management, recruitment, infection control and medicines systems.
- Effective?
- Good
- People's health, eating, training and support needs were generally met. Some mental capacity assessments needed to be more detailed and specific to each decision.
- Caring?
- Good
- Staff were observed to be kind and caring. People and relatives were involved in decisions, and staff supported privacy, dignity, relationships and independence.
- Responsive?
- Good
- Care plans reflected people's preferences, communication needs and activities. However, some plans gave very limited guidance about how goals should be achieved and the support needed.
- Well-led?
- Good
- Inspectors found strong quality checks, open management and regular involvement of people, staff, families and professionals.
What inspectors found, April 2020
Rated Good; inspectors found safe, kind and personalised care, with some records needing improvement.
The inspection took place on 9 March 2020. Two inspectors spoke with people, staff and a relative. They reviewed care records, medicines records, staff files, training information and quality checks.
The home supported four people, although it could support up to eight. Inspectors found enough trained staff, safe medicines practice, good links with health professionals and clean, well-maintained surroundings. People were supported to make choices, build independence, keep relationships and take part in activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was a planned inspection because the previous rating was Good. The overall rating remained Good.
Safe staffing
There were enough staff to support people at home and during activities and trips out. Staff responded promptly and formed a consistent team.
“The home was well-staffed. There were enough staff to support people in the home and on trips out and activities in the community.” from the report
Kind relationships
Staff knew people well and were seen to be kind and relaxed. They supported people to stay connected with relatives and friends.
“Staff provided care and support in a caring and meaningful way. They knew the people who used the service well and had built up kind and compassionate relationships with them.” from the report
Building independence
People were supported to learn everyday skills, make choices and work towards living more independently.
“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
Activities and community life
People took part in activities they enjoyed, including shopping, leisure activities, education, volunteering and visits to relatives.
“People were supported to be involved in a range of activities that they enjoyed.” from the report
Clean and safe home
The home was clean, tidy and well maintained. Staff had infection control training and used protective equipment.
“The home was clean, tidy and well maintained throughout.” from the report
Strong oversight
The manager and provider used audits, meetings and reports to monitor the service and identify improvements.
“Quality assurance processes were robust to give oversight of the service.” from the report
Mental capacity records
needs fixingSome mental capacity assessments were not specific enough to the decision being made. One did not explain in detail how the conclusion had been reached, although the manager arranged refresher training and an external audit.
“The assessments were not always decision specific and for one person we found the assessment had no detailed record as to how the decision was arrived at of the person not having capacity.” from the report
Care plan guidance
needs fixingCare plans recorded people's goals, but some gave very limited information about how those goals should be achieved and how much support was needed. The manager agreed to review them, and inspectors found no evidence that this had affected people's care.
“However, the guidance was extremely limited, regarding how goals were to be achieved and the level of support required.” from the report
- 01How have you updated the mental capacity assessments since this inspection, and are they now specific to each decision?
- 02How do care plans explain the steps towards each person's goals and the level of support they need?
- 03How do you check that staffing levels remain enough when people go out or take part in community activities?
- 04How are people involved in reviewing their care plans and choosing activities?
- 05How do you involve relatives and health professionals when a person's needs or behaviour changes?
This was a planned inspection covering all five CQC questions, and both the care provided and the home itself were looked at. This explanation was written from the published report of 25 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.
What inspectors found, September 2017
Rated Good; inspectors found safe, kind and personalised care, with some improvements needed in training, fire drills and complaint feedback.
This was an unannounced inspection on 4 and 7 August 2017. One inspector and an expert by experience spoke with people living at the home, relatives and staff. They also checked care records, medicines, recruitment, training and management records.
The home supported seven people with learning disabilities and mental health needs, and was registered for up to eight people. Inspectors found enough staff, safe medicines support, appropriate risk assessments and positive relationships between people and staff.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors did identify some follow-up points, including fire drill participation, autism training for some staff, awareness of safeguarding agencies and evidence of feedback after complaints.
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs, and recruitment checks had been completed before staff started work.
“People were supported by staff who had been through required recruitment checks to prevent unsuitable people providing care and support.” from the report
Respectful care
Staff understood people's communication, respected their choices and supported them to decide when to get up and go to bed.
“We saw that staff assisted a person to help them communicate. They showed good understanding of the person's verbal communication.” from the report
Individual support
Care plans reflected people's changing needs. Activities were planned around people's interests and the people they wanted to spend time with.
“The plans had been kept up to date with people's changing needs.” from the report
Positive management culture
People's views were sought through meetings and surveys. Inspectors saw positive relationships between people, staff and the manager.
“We saw many positive, friendly interactions between staff members and the registered manager and people living at the service.” from the report
Safeguarding knowledge
needs fixingNot all staff knew which outside agencies to contact if safeguarding concerns arose. The manager said this would be followed up.
“though not all staff were aware of relevant external agencies to refer to if necessary.” from the report
Fire drill participation
needs fixingInspectors found that some staff had not taken part in fire drills for some time. The manager said this would be addressed.
“We queried why some staff had not taken part in fire drills for some time.” from the report
Autism training
needs fixingSome staff had not been trained in autism even though some people living at the home had this diagnosis. The manager later said training had been arranged.
“Some staff were not trained in autism despite some people using the service being diagnosed with this condition.” from the report
Complaint feedback
minorComplaint records showed the outcomes, but inspectors did not see evidence that feedback had been given to the complainant. The manager later said a response had been provided in a suitable format.
“There was no evidence of feedback to the complainant.” from the report
- 01Have all staff now taken part in fire drills, and how often are drills carried out?
- 02Have all staff completed autism training, and how is this training used in people's care?
- 03What safeguarding agencies should staff contact if they are worried about someone's safety?
- 04How are complaints answered, and how do you record that the person making the complaint received feedback?
- 05How are people's choices about activities, routines and communication recorded and reviewed?
This was an unannounced comprehensive inspection covering all five quality areas, with detailed checks of two people's care records and the home's medicines, staffing, training and management records. This explanation was written from the published report of 14 September 2017 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 Toller Road
3 rated inspections over 5 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Registered with the Care Quality Commission on 3 September 2013.
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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