CQC report explained · a nursing home
What the CQC found at Treloar College
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Students were protected from avoidable harm and abuse. Inspectors found suitable staffing, detailed risk assessments, safe medicines arrangements and appropriate recruitment checks.
- Effective?
- Outstanding
- Staff received comprehensive training tailored to students' needs. Students had access to in-house nursing, GP and therapy support, and received exceptional help with eating, drinking and special diets.
- Caring?
- Outstanding
- Staff had excellent relationships with students and supported them to communicate, make decisions and become more independent. Inspectors found that privacy, dignity, cultural needs and personal choices were respected.
- Responsive?
- Outstanding
- Care plans were detailed, regularly reviewed and based on students' needs, preferences and goals. The home offered many activities and had thorough arrangements for students moving into college and preparing for life afterwards.
- Well-led?
- Outstanding
- Inspectors found an open and empowering culture focused on students. Students and staff helped shape improvements, and quality checks, audits and management systems supported continuous improvement.
What inspectors found, October 2017
Rated Outstanding; inspectors found highly personalised care, strong support for independence and excellent leadership, with safety rated Good.
Inspectors visited without notice on 7 and 8 June 2017. They spoke with 19 students, 31 staff and 14 members of the management team. They also observed care and reviewed care plans, records, complaints, training and surveys.
The overall rating was Outstanding, compared with Good at the previous inspection. Safety was rated Good. Effectiveness, caring, responsiveness and leadership were all rated Outstanding.
Inspectors found thorough risk assessments that helped students take part in activities safely and build independence. Medicines were stored and given safely, staffing levels were suitable, and staff had detailed training for students' individual needs.
The report describes strong relationships between staff and students. It also found detailed care planning, excellent use of communication technology, creative food support for students with swallowing difficulties, and thorough planning for moving into and out of the college.
Promoting independence
Risk assessments were used to help students take part in activities safely rather than unnecessarily restricting them. Assistive technology was adapted to help students communicate, make choices and do more for themselves.
“The focus of risk assessments was clearly to enable students to meet their goals safely.” from the report
Highly personalised communication
The home used pictures, interpreters, signers and customised technology to help students express their views. Communication plans gave staff detailed guidance about each student's abilities.
“There was highly imaginative use of technology to support students' independence and dignity.” from the report
Specialist food support
Students with swallowing difficulties received attractive food made safe for them to eat. The home also supported religious diets, healthy choices and different levels of independence with cooking.
“The college's investment in specialist kitchen facilities removed restrictions and allowed all students to enjoy celebrations involving food equally.” from the report
Kind and respectful care
Inspectors saw friendly, cheerful interactions. Students said they were involved in care planning, listened to when they wanted changes and treated with respect for their privacy and dignity.
“We saw kind and caring staff who assisted students whilst encouraging them to do as much as possible themselves.” from the report
Strong planning and leadership
Care plans were regularly reviewed by several professional teams. Students took part in the running of the home through councils, governors, meetings and feedback systems.
“There was an open, empowering ethos at the college which put the students at the centre of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and review my relative's needs before they move in, including their health, communication, mobility and dietary needs?
- 02How would you help my relative communicate consent, make decisions and raise a complaint or concern?
- 03What specialist training would the staff supporting my relative receive, and how would their competence be checked?
- 04How would you support my relative to take part in activities safely while building their independence?
- 05How would you plan and support my relative's move on to further education, residential care or more independent living?
This was an unannounced inspection of the residential accommodation, healthcare provision and care and support provided outside the educational curriculum, covering all five CQC questions. This explanation was written from the published report of 18 October 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. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, January 2017
Rated Good; inspectors found safe, person-centred medicines and feeding support, but some checks and topical medicine guidance needed improvement.
This was an unannounced, focused inspection on 8 December 2016. It followed concerns about medicines given through feeding tubes. Inspectors looked only at safety in medicines and enteral feeding, not the full service.
Inspectors reviewed 10 care plans, six staff training records, medicine records, incident reports and audits. They observed medicines being given to two students and medicines being given through a feeding tube to one student.
They found clear care plans, trained staff and effective support from healthcare professionals. Medicines were available, stored safely and usually given as prescribed. The overall rating and the Safe rating stayed Good, as they had been after the previous comprehensive inspection.
There were some shortfalls. Annual competency checks for some staff were overdue. The home did not use body maps or clear care-plan instructions for topical medicines. Inspectors were also not assured that emergency medicines were easily accessible overnight.
Clear individual guidance
Care plans and electronic medicine records gave staff detailed instructions about feeding tubes, medicines, timing and individual needs.
“Records showed that the guidance available to staff was comprehensive.” from the report
Trained staff
Staff received training and competency assessments before giving medicines or providing enteral feeding without supervision.
“Only appropriately trained staff were able to support students with their medicines and with enteral feeding.” from the report
Safe medicine systems
Medicines were available, in date, securely stored and checked. Staff recorded administration and controlled drugs were checked twice daily.
“The service had processes in place to ensure that people received their medicines as prescribed.” from the report
Learning from incidents
The home reviewed medicine and feeding errors, then used the findings to make changes to training, storage and care arrangements.
“Records showed that when an error in medicines administration had occurred this was recorded and reviewed by the clinical lead.” from the report
Overdue competency checks
needs fixingSome annual checks of staff competence in medicines and enteral feeding had not been completed. These checks were intended to make sure staff remained safe and competent.
“Whilst we saw evidence that some staff had completed these checks, in the staff records we reviewed these annual competency checks had not always been completed.” from the report
Topical medicine instructions
needs fixingCare plans did not explain clearly where and how topical creams and ointments should be applied. Inspectors made a recommendation to improve this practice.
“The service did not use body maps or have information in care plans to inform staff when and how to apply the medicines to make sure the medicines were used effectively.” from the report
Overnight emergency access
needs fixingInspectors were not assured that emergency medicines could be accessed easily overnight when only one clinical team member was working. The home said it was reviewing and changing its arrangements.
“We were not assured that the medicines were easily accessible overnight when only one member of the clinical team was working.” from the report
- 01Have all staff who give medicines or enteral feeding now completed their annual competency checks?
- 02What changes were made to ensure emergency medicines are available in students' accommodation overnight?
- 03How are staff told exactly where and how to apply each student's topical creams or ointments?
- 04How are medicine and enteral feeding errors reviewed, and what changes have been made as a result?
- 05How are each student's feeding tube instructions and medicine guidance checked and updated when their needs change?
This was a focused inspection of Safe, covering medicines and enteral feeding only; the overall and Safe ratings carried over as Good from the previous comprehensive inspection. This explanation was written from the published report of 26 January 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 Treloar College
3 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- October 2017Outstandingcurrent ratingup from GoodSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- January 2017Goodstayed GoodSafe: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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