CQC report explained · a residential care home
What the CQC found at Tuscany House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2022
Rated Requires Improvement; inspectors found kind care and good health support, but unsafe medicines, missed activities and inconsistent leadership.
Inspectors visited on 31 March, 1 April and 5 April 2022. They spoke with staff and relatives, observed care, and checked care records, medicines, recruitment, training and quality checks. There was no registered manager in post.
The home was caring and effective overall. Staff were kind, respectful and supported people with healthcare, food, independence and some activities. The home was clean, infection controls were suitable, and there were enough staff to keep people safe, although agency staff were regularly used.
There were important weaknesses. Some medicines were given after their expiry date, and guidance for medicines given when needed was not clear enough. Some people did not have enough meaningful activities or community access. Care plans did not always reflect current needs, and staff lacked training in Makaton, used by two people.
Leadership had been unsettled, with several management changes and gaps in supervision and quality checks. The overall rating Requires Improvement means the home was not consistently meeting people's needs or providing enough assurance about safety and quality.
Kind and respectful staff
Relatives described staff as kind and friendly. Inspectors saw staff spending time with people and supporting their dignity and independence.
“Staff engaged with people in a friendly yet professional manner.” from the report
Healthcare support
People were supported to access healthcare professionals when needed. Ongoing health conditions were monitored by relevant specialists.
“If people developed healthcare needs, staff ensured they had access to appropriate professional input.” from the report
Safeguarding arrangements
Staff knew how to recognise and report abuse. Previous safeguarding concerns had been reported and investigated, and procedures for protecting people's money had been strengthened.
“When safeguarding concerns had been raised in the past, staff had notified appropriate agencies and investigated the concerns when asked to do so.” from the report
Clean and hygienic home
Inspectors found suitable infection prevention arrangements, including safe use of protective equipment, testing and hygiene practices.
“We were assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
Food and choice
People were supported to choose food and maintain a balanced diet. Staff knew people's likes and dislikes and encouraged their involvement in menu planning.
“People were supported to make choices about what they ate and to maintain a balanced diet.” from the report
Medicines were not always safe
seriousSome medicines had been given after they expired. Guidance for medicines given when needed was not always clear, and audits had not found the problems.
“Some medicines had been administered after they had expired and there was insufficient guidance for staff about the use of medicines prescribed 'when required'.” from the report
Care plans were not current
needs fixingSome care plans did not reflect people's current needs or explain how staff should support them effectively. People were not consistently involved in developing their support plans.
“People's support plans did not reflect their current needs or include guidance for staff about how to support people effectively.” from the report
Communication training gap
needs fixingTwo people used Makaton, but current staff had not received Makaton training. The report recommends making suitable training available.
“Training records indicated staff currently working at the home had not received Makaton training.” from the report
Unsettled management
needs fixingSeveral managers had left or changed within a short period. This affected staff supervision, team meetings, documentation and the consistency of care.
“The frequent changes in management had led to expected standards not being maintained across a number of areas.” from the report
Quality checks were not effective
seriousThe provider's monitoring systems had not identified important problems and did not sufficiently seek the views of people, relatives and staff.
“The failure to assess, monitor and improve the quality of the service, including the quality of people's experience, was a breach of regulation 17” from the report
- 01What checks now prevent medicines being given after their expiry date?
- 02How will you make sure guidance for medicines given when needed is clear for every staff member?
- 03What activities and community access will be available for people who need two staff or an authorised driver?
- 04When will current care plans be reviewed, and how will people be involved in writing them?
- 05What Makaton training have staff received, or when will this be provided?
This was the first comprehensive inspection under the current provider and assessed all five key questions; it also included infection prevention and control checks. This explanation was written from the published report of 30 April 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 Tuscany House
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- April 2022Requires improvementcurrent ratingdown from OutstandingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2019Outstandingup from GoodSafe: OutstandingEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020
Registered with the Care Quality Commission on 1 December 2020.
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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77 live-in carers within about an hour of Surrey
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 £1,250 a week. 66 can care for a couple. 11 years' experience on average.
“Without his support we wouldn't have been able to navigate bringing and keeping Dad at home.”
“Not only has she looked after him beautifully, she has also been great company for him with lively conversation, kindness and humour.”
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.