CQC report explained · a nursing home
What the CQC found at Trelana
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Some people became distressed because of their health needs, and this left others anxious or unsettled. Medicines, risk assessments, recruitment checks and building safety systems were otherwise described as robust.
- Effective?
- Good
- Staff had induction, training, supervision and regular updates. People had choices about food and where they ate, although records did not always clearly show powers of attorney or valid consent.
- Caring?
- Good
- Inspectors saw kind and sensitive interactions, with staff reassuring people and helping them with dignity. However, bedroom doors were often left open and one staff member entered without knocking.
- Responsive?
- Good
- Care plans were detailed and reviewed regularly. People had access to activities suited to their interests, although monitoring records and pressure-relieving mattress settings were not always managed correctly.
- Well-led?
- Good
- The managers were active, approachable and committed to improvement. Audits, meetings, feedback systems and action plans were in place.
What inspectors found, November 2017
Rated Good overall, but the home Requires Improvement for safe care because some people became distressed and others felt anxious.
This was an unannounced inspection on 28 September 2017. Inspectors spoke with people living in the home, relatives, staff and health professionals. They observed care, checked the building and reviewed care, staff and management records.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Safe was rated Requires Improvement because some people became distressed and this made others anxious or unsettled. Inspectors also found concerns about staffing at busy times, privacy, records and some equipment checks.
There were also important strengths. Medicines were given safely, staff had suitable training and recruitment checks, and people were generally treated with kindness and respect. The home acted on several issues during or after the inspection, including arranging one-to-one support and improving checks on specialist mattresses.
Medicines
Medicines were stored, administered and checked safely. Records and monitoring systems helped reduce the risk of errors.
“People received their medicines as prescribed and on time.” from the report
Kind care
Inspectors saw staff reassuring people, respecting their needs and supporting them in a calm and friendly way.
“People were cared for by staff who were caring and sensitive to people's needs.” from the report
Staff preparation
New staff received an induction and worked alongside experienced staff. Training covered both general care and the needs of people living in the home.
“There was also a period of working alongside more experienced staff until such a time as the worker felt confident to work alone.” from the report
Care planning
Care plans contained information about people's needs, preferences and the support they required. They were reviewed monthly or when needs changed.
“Care plans gave details about each person's needs and were reviewed monthly or as people's needs changed.” from the report
Active management
The management team used audits, meetings and action plans to identify and address issues. The manager was described as supportive and approachable.
“There were quality assurance systems in place to help identify any gaps in the delivery of care or areas for improvement.” from the report
Distress affecting others
seriousOne person could become verbally aggressive when distressed. Other people were fearful or avoided a shared lounge, and inspectors were concerned that support was not always provided quickly enough.
“We were concerned staff were not always able to meet the person's needs in a timely manner to avoid any loud and aggressive outbursts which could make others fearful.” from the report
Staffing pressure
needs fixingRelatives and staff said there were not always enough staff, especially in the dementia unit. Some people sometimes had to wait for support, although the service had recently recruited more staff.
“Staff and relatives told us there were not always enough staff to meet people's needs.” from the report
Privacy
needs fixingBedroom doors were generally left open, which meant people could be seen by passers-by. Inspectors also saw a staff member enter a bedroom without knocking.
“This did not protect people's privacy and dignity.” from the report
Care records and mattresses
needs fixingSome monitoring records did not show that checks were completed as planned. Pressure-relieving mattresses were not always set correctly for people's weights.
“The records had not always been completed appropriately to document this was occurring in line with people's care plan.” from the report
Legal decision-making records
minorCare plans did not always clearly record whether someone had a lasting power of attorney or what type it was. This could make it unclear who had legal authority to make decisions.
“Care plans did not always clearly document when people had an LPA and what type this was.” from the report
- 01How do you now make sure people who become distressed receive timely support and that other residents feel safe?
- 02What staffing levels are normally in place in the dementia unit, and what cover is available when staff are absent?
- 03How are pressure-relieving mattresses now checked and set for each person's weight?
- 04How do you make sure staff knock before entering bedrooms and protect people's privacy?
- 05How do you record lasting powers of attorney and confirm who can make decisions for a resident?
This was an unannounced inspection covering all five CQC questions, with observations, discussions and checks of care, staff and management records. This explanation was written from the published report of 3 November 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 Trelana
2 rated inspections over 2 years: the service has held its Good rating throughout.
- November 2017Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015
Registered with the Care Quality Commission on 17 April 2015.
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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10 live-in carers within about two hours of Cornwall
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 £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
“He had been a little anxious before she arrived, but has since stated that he would be very happy for her to care for him again”
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.