CQC report explained · a residential care home
What the CQC found at Tralee Rest Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2023
Rated Requires Improvement; inspectors found serious safety and management weaknesses, with the well-led rating Inadequate.
This was an unannounced focused inspection on 13 and 23 December 2022. One inspector spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The home had enough staff and people and relatives spoke positively about staff being kind and friendly. However, people were not always protected from risks linked to fire, falls, choking, diabetes, medicines and infection.
The home’s checks and records had not found or dealt with important problems. Care plans and risk assessments were incomplete, some professional advice was not followed, and staff training did not cover all the support they provided.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe was rated Requires Improvement and well-led was rated Inadequate. The provider dealt with some issues during the inspection, but CQC took enforcement action over governance.
Kind staff
People and relatives were positive about staff. Staff spoke kindly to people and were happy to spend time with them.
“People and their relatives were positive about the staff who provided support to them.” from the report
Enough staff
Inspectors found enough staff to support people, and staff responded to requests for help promptly during the visit.
“There was enough staff to provide support to people.” from the report
Safe recruitment
The provider carried out recruitment checks, including checks intended to help make safer recruitment decisions.
“Staff had been recruited safely.” from the report
Choice and legal safeguards
People were offered day-to-day choices. Staff understood how to support decision-making and work in people’s best interests when needed.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Fire and environmental risks
seriousFire evacuation equipment had been removed and fire drills had not been completed. Unsafe stair gates, uneven flooring, missing bed controls and a damaged plug socket also created risks.
“If there had been a fire, staff would not have the equipment they needed to move people to safety.” from the report
Medicines storage
seriousThe medicines room was above the recommended temperature on several days, which could affect whether medicines remained effective. This was a breach of Regulation 12.
“Medicines had not always been managed safely.” from the report
Incomplete care records
seriousCare records and risk assessments did not always explain the support people needed. There were significant gaps in records of continence support.
“Care records needed improvement to enable people's support to be monitored to ensure they were well supported.” from the report
Advice not followed
seriousStaff did not always follow health professionals’ guidance, including guidance about a modified diet for someone at risk of choking.
“Health care professionals had assessed that the person needed a modified diet to remain safe.” from the report
Weak management checks
seriousAudits had not found important risks, and the provider had not acted quickly enough on issues raised by staff. This led to a breach of Regulation 17.
“Quality assurance systems needed improvement as some concerns had not been identified and mitigated.” from the report
Gaps in training
needs fixingSome staff had not completed training relevant to the support they provided, including choking, aspiration and catheter care.
“The provider had not invested in providing staff with a wide range of training appropriate to the role.” from the report
- 01What has been done to replace and check the fire evacuation equipment, and how often are fire drills now carried out?
- 02How are medicines kept below the required temperature, and how are temperature records checked?
- 03How are care plans and risk assessments kept up to date for choking, diabetes, asthma, mobility and continence support?
- 04What action has been taken to make sure staff complete training in choking, aspiration and catheter care before providing this support?
- 05What improvements have been made to the governance and audit systems since the inspection, and what evidence can families see?
This was a focused inspection of Safe and Well-led only; the other key-question ratings were carried forward from the previous inspection when calculating the overall rating. This explanation was written from the published report of 9 February 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, December 2021
Rated Good; inspectors found safe, kind and personalised care, with a few minor issues dealt with during or after the inspection.
Inspectors visited unannounced on 2 and 3 November 2021. They spoke with eight people, one relative, eight staff members and six relatives or friends who gave written feedback. They also observed care and checked care, medicine, recruitment and management records.
The home was caring and person-centred. People said they felt safe and were happy with the care, food and activities. Staff knew people well, respected their choices and supported contact with families. The home also helped people access health professionals and provided support at the end of life.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This means inspectors found people were safe, their needs were met, they were treated with kindness and dignity, and the home was managed effectively.
Inspectors found a staff member wearing the wrong type of mask. This was corrected during the inspection. Two worn bedroom carpets were replaced after the inspection, and an audit had identified a concern about the safe storage of medicines that was being addressed.
People felt safe
People told inspectors they felt safe and that staff were available when needed. Staff understood people's risks and how to reduce them.
“One person told us, "I do feel safe here and they look after me well.” from the report
Kind, respectful care
Inspectors saw a warm atmosphere. Staff spoke kindly, offered reassurance and respected people's privacy, dignity and preferred ways of being addressed.
“Staff spoke kindly to people and provided comfort and reassurance to people when they were upset.” from the report
Personalised support
Care plans included people's life history, routines and preferences. Staff knew what mattered to people and involved them in decisions about daily care.
“Care plans included the 'This is me' tool.” from the report
Good management and feedback
Staff felt supported and listened to. The home used meetings, surveys and audits to gather views and identify improvements.
“There was a system of audits in place at the service.” from the report
Infection control lapse
minorOne staff member was not wearing the correct type of mask. The manager obtained advice and corrected this during the inspection.
“One member of staff was not wearing the correct type of mask.” from the report
Worn bedroom carpets
needs fixingTwo bedroom carpets were becoming worn and presented a trip hazard. The provider arranged for them to be replaced immediately after the inspection.
“There were two bedrooms where the carpet was becoming worn and needed replacement before further wear occurred and they presented a trip hazard to people.” from the report
Medicine storage check
needs fixingThe home's audits identified a concern about the safe storage of medicines. The report says action was being taken to address it.
“For example, auditing had identified a concern in relation to the safe storage of medicines.” from the report
- 01What action was taken to make medicine storage safe, and how is this checked now?
- 02How do you check bedrooms and equipment for trip hazards after the worn carpets were replaced?
- 03How do you make sure all staff follow the current mask and infection control guidance?
- 04How will my relative's activities be supported when the activities co-ordinator is away?
- 05How will my relative and our family be involved in reviews of their care and decisions about their support?
This was an unannounced planned inspection of the newly registered service covering all five key questions, and it was the first inspection of this service. This explanation was written from the published report of 17 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.
Every inspection of Tralee Rest Home
2 rated inspections over a year: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- December 2021GoodSafe: GoodWell-led: Good
- September 2019
Registered with the Care Quality Commission on 4 September 2019.
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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