CQC report explained · a residential care home
What the CQC found at Tusker House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors looked only at infection prevention and control. They found the home clean, appropriate PPE in use, regular testing and systems to manage a possible outbreak.
- Effective?
- Good
- People's needs and choices were assessed and reviewed. Staff had relevant training, people received suitable food and drink, and healthcare needs were followed up.
- Caring?
- Good
- This question was not reviewed during this focused inspection.
- Responsive?
- Good
- This question was not reviewed during this focused inspection.
- Well-led?
- Good
- The provider had improved audits, care records and action plans. Inspectors found a positive culture, staff who knew people well and open communication with relatives and staff.
What inspectors found, July 2021
Rated Good; inspectors found effective, person-centred care and good leadership, while infection control was inspected but not rated.
The unannounced inspection took place on 22 June 2021. One inspector spoke with people, a relative, staff and other relatives, and reviewed care records, training information and management records.
The home was clean and tidy. Staff used personal protective equipment correctly, testing was carried out, and relatives were supported to visit safely. People received suitable food, drinks and healthcare, and staff had the training and support needed to care for them.
Mental capacity assessments and best-interest decisions had improved since the last inspection. Care plans, daily notes and quality checks had also improved. The home had a positive culture and staff knew people well.
The overall rating was Good. Effective and Well-led were rated Good. Safe was inspected only for infection prevention and control, so it was not re-rated. Caring and Responsive were not reviewed in this focused inspection.
Infection control
The home was clean, PPE was used properly and systems were in place for testing and managing infection risks.
“The home was clean and tidy throughout. Changes had been made to the cleaning schedule to ensure increased cleaning of high-touch areas.” from the report
Consent and choice
Mental capacity assessments were specific to individual decisions. Best-interest decisions involved people, relatives where possible, staff and professionals.
“Mental capacity assessments were specific to individual decisions.” from the report
Staff preparation
New staff completed face-to-face training and an induction before working unsupported. Training was linked to the needs of people living in the home.
“During this time, they worked with senior care staff to get to know people and understand their needs until they were assessed as confident and competent to work with people unsupported.” from the report
Improved records and checks
Care plans and risk assessments contained the information staff needed. Audits identified improvements and action plans were used to follow them up.
“The quality assurance system had been reviewed. Regular audits and checks had taken place.” from the report
Positive culture
Inspectors found that staff knew people well and understood person-centred care. Relatives said they could raise concerns with the provider.
“There was a positive culture at the home.” from the report
Visitor testing
minorSome relatives found the requirement for both a PCR test and an LFD test before each visit burdensome. The provider said it would review the policy and consider supporting relatives to take an LFD test at home where safe.
“Some relatives told us they found this burdensome and unnecessary.” from the report
Recent reduction in training
minorSome staff said there had been less training during the pandemic. Training had restarted and a programme was in place for the coming months.
“Some staff told us there had been less training recently.” from the report
- 01What has changed in the visitor testing policy since the inspection?
- 02How will you make sure all staff complete the training and updates planned for the coming months?
- 03How are mental capacity assessments and best-interest decisions kept up to date for my relative?
- 04How will my relative's care plan record their activities, choices and changing needs?
- 05How will you respond if my relative's health, nutrition or hydration needs change?
This was a focused inspection of Effective and Well-led, with infection prevention and control checked under Safe; Safe was not re-rated and Caring and Responsive were not reviewed. This explanation was written from the published report of 10 July 2021 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, September 2019
Rated Requires Improvement; inspectors found safe, kind, person-centred care, but records, mental-capacity decisions and quality checks needed work.
This was an unannounced inspection on 29 and 30 July 2019. The inspector and an expert by experience reviewed records, medicines, recruitment, complaints, accidents, care plans and audits. They spoke with people living at the home, visitors and staff, and observed care and mealtimes.
People were generally safe, treated kindly and supported with their individual needs. Inspectors found enough staff, safe medicines procedures, good cleanliness, suitable training, healthcare support and freshly cooked meals. People and visitors described the home as friendly and happy.
The main weaknesses were in recording and checking care. Mental capacity assessments and best-interest decisions had not been recorded for important decisions. Care plans did not always contain enough detail, and records did not fully show people's activities or choices. The quality assurance system had not found these problems.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, Caring and Responsive were rated Good. Effective and Well-led were rated Requires Improvement.
Kind and respectful care
People said staff were kind and respectful. Inspectors saw a calm, friendly atmosphere and staff who knew people's histories, likes and needs.
“People were supported by staff who were kind and caring. They treated people with compassion and patience.” from the report
Staffing and safety
Inspectors found enough staff to respond promptly to people's needs. Staff understood safeguarding and individual risks, and recruitment checks were completed.
“There were enough staff working each shift to ensure people's needs were met in a timely way.” from the report
Safe medicines
Medicines were ordered, stored, given and recorded safely. Staff giving medicines had training and competency checks.
“Medicines were ordered, stored, administered and disposed of safely.” from the report
Food and healthcare
People received a choice of freshly cooked food, drinks and snacks. The home supported people to see healthcare professionals when needed.
“People were supported to eat a wide range of healthy, freshly cooked meals, drinks and snacks each day.” from the report
Mental capacity records
needs fixingAssessments had not been completed for important care decisions, including the use of alert mats. Some relatives had signed consent forms without having the legal authority to do so.
“Mental capacity assessments had not been completed in relation to key decisions that had been made regarding people's care.” from the report
Care records lacked detail
needs fixingSome care plans and risk assessments did not explain people's preferences or the support they needed in enough detail. Inspectors said staff knew people well, but this knowledge was not fully recorded.
“Some aspects of record keeping needed to be improved. Care plans and risk assessments did not contain all the information staff may need.” from the report
Activities were not always individual
needs fixingThere was a range of activities, but not everyone had enough opportunities for activities matching their interests. Activity records did not fully show what each person had done.
“Improvements were needed to ensure everybody was given the opportunity to take part in activities that were meaningful and reflected their individual interests.” from the report
Quality checks missed problems
needs fixingThe quality assurance system had not identified the gaps in mental capacity assessments, best-interest decisions and record keeping.
“This had not identified the shortfalls in relation to mental capacity. Mental capacity assessments had best interest decisions had not been completed.” from the report
- 01Have mental capacity assessments and best-interest decisions now been completed for every important care decision?
- 02How do you make sure relatives only sign consent forms when they have the legal authority to do so?
- 03How do care plans record each person's preferences, including personal care choices and responses to distress?
- 04How are activities matched to each person's interests, and how is participation recorded?
- 05What checks are now used to make sure the quality assurance system identifies gaps in care records?
This was an unannounced inspection covering all five CQC questions; inspectors reviewed a sample of three care plans and risk assessments, tracked two people's care, and spoke with people, visitors and staff. This explanation was written from the published report of 7 September 2019 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 Tusker House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2019Requires improvementdown from GoodEffective: Requires improvementWell-led: Requires improvement
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 11 April 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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19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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.