CQC report explained · a residential care home
What the CQC found at Tunstall Hall Care Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2022
Tunstall Hall Care Centre rated Requires Improvement; inspectors found kind, person-centred care, but safety and management systems were not reliable.
This was an unannounced inspection on 2 and 3 August 2022. Inspectors spoke with people, relatives and staff, and checked care records, medicines records, staff files and management records.
The home was rated Good for Effective, Caring and Responsive care. People were described as receiving kind, respectful and personalised support. Staff knew people well, training was provided, food met people’s needs and activities and relationships were supported.
Safe and Well-led were rated Requires Improvement. Inspectors found gaps in risk assessments, weight checks, medicines management, infection control, call bell monitoring and quality checks. The overall rating fell from Good at the previous inspection, published in December 2018.
The home made changes during and after the inspection, including new risk assessments, medicine checks, call bell monitoring and extra staffing during COVID-19 outbreaks. The CQC said these changes would be checked at the next inspection.
Kind and respectful staff
People and relatives described staff as kind, compassionate and respectful. Staff supported people’s privacy, dignity and independence.
“People felt valued by kind and compassionate staff.” from the report
Staff training
Staff received a detailed induction, ongoing training and supervision. Extra support was provided when staff were unsure how to apply their training.
“Staff received a comprehensive induction and on-going training.” from the report
Personalised support
Staff knew people’s likes, dislikes and support needs. Care plans included individual choices, communication needs and meaningful activities.
“Staff understood people's needs and preferences. They spoke knowledgably about tailoring the level of support to individual's needs.” from the report
End of life care
End of life plans recorded people’s wishes and religious preferences. Inspectors saw examples of the home supporting people’s final wishes.
“People who were nearing the end of their life, received compassionate and supportive care.” from the report
Risk assessments and weight checks
seriousSome people did not have risk assessments for specific behaviours or health conditions. There were also unexplained gaps in weight monitoring for people at risk of losing weight.
“Risks to people were not always assessed or mitigated.” from the report
Medicines management
seriousOne person missed medicines for two days because the stock had run out. Medicines were not always stored safely, and records did not show that pain relief patches were always rotated correctly.
“We found one person did not receive medicines for two days as their medicine stock had run out.” from the report
Call bell response times
seriousPeople sometimes waited a long time for call bells to be answered. On one occasion, the wait was more than 17 minutes.
“On one occasion, a person waited over 17 minutes for the call bell to be answered.” from the report
Quality checks missed problems
seriousAudits and monitoring systems were in place but did not identify several safety and medicines concerns. Problems found on the first inspection day were still present on the second day.
“We found while processes were in place, risks and areas of concern were not effectively identified.” from the report
Infection control
seriousDuring a COVID-19 outbreak, visitors were not asked for lateral flow test results on either inspection day. A hand safety policy was also not followed by a member of the management team.
“We were not assured the provider was preventing visitors from catching and spreading infections.” from the report
- 01What evidence can you show that people now have complete risk assessments for their health conditions and specific behaviours?
- 02How do you now check medicine stocks, storage temperatures and pain relief patch locations?
- 03How are call bell response times monitored, both during and outside COVID-19 outbreaks?
- 04How do you check that infection control procedures, including visitor testing and hand safety, are followed?
- 05What action plan was sent to the CQC, and what progress has been made on each action?
This unannounced inspection considered all five key questions, with infection prevention and control also checked under Safe; the report says the previous comprehensive inspection was published in 2018. This explanation was written from the published report of 10 September 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.
What inspectors found, December 2018
Rated Good; inspectors found kind, responsive care and safe systems, but noted a medicines labelling issue and some pressure when staff were off sick.
This was an unannounced comprehensive inspection on 15 November 2018. Inspectors spoke with people living at the home, relatives, care staff and managers. They looked at care records, a staff recruitment file, management records and medicine records.
The home was rated Good overall and remained Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff to meet people's needs, personalised care, kind interactions, activities and systems for handling complaints and improving the service.
There were some issues to watch. Staff had not always written the opening date on medicine bottles and boxes, which could increase the risk of out-of-date medicines. The manager corrected this during the inspection. Inspectors also heard that staffing could be low when staff called in sick and that some staff wanted more activities.
Kind and respectful care
Inspectors saw staff respond patiently and compassionately when someone became distressed. Staff also protected people's dignity when providing personal care.
“We observed positive interactions between people and staff during our inspection and staff showed patience and compassion when supporting people.” from the report
Personalised care
Care plans recorded people's preferences and wishes. Staff used these records to support people in an individual way and promote independence.
“Care plans were detailed and contained person-centred information that helped care staff support people in an individualised way.” from the report
Good food and choice
People were offered enough food and drink, with choices at mealtimes. The home had changed mealtime arrangements to create a more relaxed and inclusive atmosphere.
“People received enough food and drink to meet their dietary requirements.” from the report
Approachable leadership
People and relatives said the manager was friendly and approachable. The home had quality checks and action plans to address errors and improvements.
“People who used the service said that they thought the registered manager was approachable.” from the report
Staffing when people are absent
needs fixingThe manager's staffing tool showed enough staff for people's needs, but one staff member said staffing was low when colleagues called in sick. Ask how the home covers these absences.
“It is hard when staff ring in sick, that is when staffing is low.” from the report
Range of activities
minorStaff said there could be more activities and more special events. The home had a plan to make activities more personal and meaningful.
“Staff told us that they felt there could be more activities for people and that special events such as remembrance day could be celebrated with people.” from the report
- 01How do you now make sure every medicine bottle and box is dated when it is opened?
- 02What is your plan when care staff call in sick, and how do you ensure people still receive timely care?
- 03What new activities and special events have been introduced since the inspection?
- 04How often are care plans reviewed and updated?
- 05How can relatives raise a concern, and how will they be kept informed about the response?
This was an unannounced comprehensive inspection covering all five CQC questions; inspectors spoke with five people, three relatives and staff, and reviewed a limited sample of records. This explanation was written from the published report of 20 December 2018 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 Tunstall Hall Care Centre
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- September 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 9 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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