CQC report explained · a residential care home
What the CQC found at Trecarrel Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by safeguarding systems, detailed risk assessments, safe recruitment and sufficient staffing. Medicines, equipment, infection control and emergency arrangements were also checked and found to be safe.
- Effective?
- Good
- Care plans reflected people's needs and choices, staff received training and supervision, and people were supported to access healthcare. Inspectors recommended better support and engagement during meals.
- Caring?
- Good
- This key question was not inspected during this focused visit.
- Responsive?
- Good
- This key question was not inspected during this focused visit.
- Well-led?
- Good
- Leadership and quality monitoring had improved. Records, audits, staff support and meetings were being used to identify and address areas for improvement.
What inspectors found, July 2023
Trecarrel Care Home is rated Good; inspectors found safe, effective care and stronger leadership, but raised concerns about mealtime support and staff teamwork.
This was an unannounced, focused inspection on 13 June 2023. Inspectors checked Safe, Effective and Well-led. They reviewed care plans, risk assessments, staff records and management records, and spoke with people, staff, relatives and healthcare professionals.
The home was rated Good for all three areas inspected. Inspectors found effective safeguarding systems, safe medicines practice, enough staff, suitable risk assessments and good infection control. People were supported to make choices and staff sought consent before providing care.
There were some shortfalls. People's views about the food were mixed, and some staff did not support people well during meals. Some staff also reported problems with teamwork. The previous rating was Requires Improvement, but the overall rating changed to Good after improvements in leadership, staff support, records and audits.
Safeguarding systems
The home had systems to protect people from abuse, and staff understood how to report concerns.
“The provider had effective safeguarding systems in place and staff knew what actions to take to help ensure people were protected from harm or abuse.” from the report
Medicines
People received medicines as prescribed. Records and audits were checked regularly, including medicines needing extra controls.
“People received their medicines as prescribed. Regular checks and audits of the medicines management system were effective.” from the report
Staffing and recruitment
Recruitment checks were thorough and inspectors found enough staff to meet people's assessed needs. New staff were inducted and supported before working alone.
“The recruitment processes were thorough. New staff confirmed they received support and induction before working alone.” from the report
Improved leadership
The new manager had improved oversight, staff support, records and quality checks. The previous breach about inconsistent leadership had been resolved.
“The manager, deputy manager and the provider had effective oversight of the service.” from the report
Safeguarding investigation
seriousSafeguarding allegations about the actions of some night staff were still being investigated when inspectors visited. The local authority safeguarding team and police had been informed.
“Prior to this inspection CQC had received safeguarding concerns from a member of the public which were being investigated by the manager at the time of this inspection.” from the report
Support during meals
needs fixingSome staff did not always engage appropriately with people during lunch. The inspectors recommended seeking advice to improve staff support at mealtimes.
“However, during the lunch service we saw some staff did not always engage with the person they were supporting during this time.” from the report
Food quality
needs fixingPeople's opinions of the food were mixed. The manager had identified possible improvements in how frozen, pre-prepared meals were prepared and presented.
“People's views on the food provided was mixed.” from the report
Staff teamwork
needs fixingSome staff reported cliques and poor teamwork. The manager was working with staff to address disharmony, and some staff had decided to leave.
“Some staff feedback was not entirely positive regarding how the care staff functioned as a team.” from the report
- 01What was the outcome of the safeguarding investigation involving some night staff, and what action was taken?
- 02How are staff being supported to engage properly with people during meals?
- 03What changes have been made to improve the quality, preparation and presentation of the meals?
- 04What steps are being taken to resolve staff disharmony, cliques and any staffing gaps?
- 05Has the manager completed the application to become the registered manager?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 5 July 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 2022
Rated Requires Improvement; inspectors found safe, caring support but inconsistent leadership, staff support and food quality needed attention.
This was an unannounced inspection on 14 October 2022. Inspectors spoke with people living in the home, a visitor, staff and health professionals. They observed care and checked care, medicines, recruitment and management records.
The home was rated Good for Safe. People were protected from abuse and avoidable harm, risks were assessed, medicines were generally given as prescribed, and infection control arrangements were suitable. Staff were described as caring, responsive and familiar to people.
The home was rated Requires Improvement for Effective and Well-led. Inspectors found mixed views about the food, gaps in staff supervision, and a long period without a registered manager. These leadership problems affected staff support and some parts of how the home was run.
The overall rating changed from Good at the previous inspection, published on 8 October 2021, to Requires Improvement. The provider had action plans, but inspectors said it was too early to know whether improvements had become established.
Kind relationships
People appeared relaxed and comfortable with staff. Staff spent time talking with people and responded promptly when help was requested.
“People were relaxed and comfortable with staff and had no hesitation in asking for help from them.” from the report
Risk management
People's risks were assessed and staff had guidance on how to reduce avoidable harm. Fire safety checks and emergency plans were also in place.
“Risks to people's safety and wellbeing were assessed and well managed.” from the report
Health support
Staff recognised changes in people's health and contacted health professionals when needed. Professionals said staff knew people well and acted on advice.
“People's health conditions were well managed, and staff engaged with external healthcare professionals including GP's, district nurses, community psychiatric nurses and dementia liaison nurse.” from the report
Infection control
Inspectors were assured that infection risks, including those linked to COVID-19, were managed appropriately. Staff used personal protective equipment and handwashing facilities safely.
“We were assured that the provider was using PPE effectively and safely.” from the report
Unstable leadership
seriousThere had been no registered manager since July 2019 and five interim managers had been recruited since then. Inspectors said this affected staff support, oversight and the running of the home.
“The lack of consistent leadership and oversight had impacted on the quality of support and supervision that staff received, and on the operation of the service.” from the report
Food quality and choice
needs fixingMost people raised concerns about the food, and inspectors found it not very appetising. The provider was asked to involve people in reviewing food quality and choice.
“The food is abysmal, it's made off site, everything comes with crumble.” from the report
Gaps in staff supervision
needs fixingStaff said changes in leadership and staff vacancies had made supervision difficult. Records showed that some supervision had not taken place.
“Staff told us that due to the impact of the changes in leadership and staffing vacancies it had been difficult to attend supervision.” from the report
Staffing affected routines
needs fixingSafe staffing levels were maintained, but vacancies and sickness sometimes affected people's routines and choice about when care was provided. On the inspection morning, breakfast was still being offered at 10:45am.
“The consequence was that people were still being offered breakfast at 10:45am.” from the report
Medicines system errors
seriousAn electronic medicines recording system had been introduced too early and without enough training, causing some errors. It was stopped and senior staff returned to paper records, which inspectors found were completed appropriately.
“This resulted in some medicine errors.” from the report
- 01Who is currently responsible for managing the home, and when will a registered manager be in post?
- 02What has changed since the inspection to make leadership stable and ensure improvement actions are completed and checked?
- 03How are residents involved in reviewing the quality, choice and suitability of the food?
- 04How often are staff receiving supervision now, and how are gaps being followed up?
- 05What medicines recording system is now used, and what checks are in place to prevent a repeat of the errors?
This was a focused inspection prompted by concerns about staffing, management and their effect on care; Safe, Effective and Well-led were rated, while Caring and Responsive were not rated in this report. This explanation was written from the published report of 1 December 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 Trecarrel Care Home
12 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- July 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2022Requires improvementdown from GoodSafe: GoodEffective: Requires improvementWell-led: Requires improvement
- October 2021GoodSafe: GoodEffective: GoodWell-led: Good
- April 2021Inspected but not ratedSafe: Inspected but not rated
- January 2021Goodstayed GoodSafe: GoodWell-led: Good
- December 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- July 2019Requires improvementup from InadequateSafe: GoodWell-led: Requires improvement
- June 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- December 2016Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 December 2010.
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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