CQC report explained · a nursing home
What the CQC found at Tyspane
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were found to be protected from abuse and avoidable harm. Inspectors found suitable staffing, safe medicines management, updated risk assessments and clean premises.
- Effective?
- Good
- This key question was not inspected during this focused visit. The previous rating was used to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous rating was used to calculate the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous rating was used to calculate the overall rating.
- Well-led?
- Good
- Inspectors found effective audits, better management support and staff who understood their roles. The service had improved since the previous inspection.
What inspectors found, April 2023
Tyspane rated Good after a focused inspection; inspectors found safe care and stronger management, but only Safe and Well-led were checked.
The inspection was unannounced and took place on 15 March 2023. Two inspectors spoke with people living in the home, relatives and staff. They observed care and reviewed care plans, risk assessments, medicines, staffing, recruitment, training and quality records.
The home was rated Good for Safe and Well-led. Inspectors found clean premises, suitable staffing, safe medicines management, updated risk assessments and effective safeguarding arrangements. Visitors were welcomed, and people and relatives said they felt safe.
The previous rating was Requires Improvement, published in January 2022. Inspectors found that improvements had been made and the home was no longer in breach of regulations. This was a focused inspection, so the other areas were not checked during this visit and their previous ratings were used in calculating the overall Good rating.
Clean and hygienic premises
The home had reviewed its premises and replaced carpets where needed. Inspectors found the premises clean and free from unpleasant smells.
“The premises were clean throughout and there were no malodours.” from the report
Safe staffing
Inspectors found enough suitably trained and experienced staff to meet people's needs. Staffing levels were regularly reviewed using a dependency tool.
“There were enough suitably trained and qualified staff to meet people's needs in a timely way.” from the report
Medicines managed safely
Staff gave medicines as prescribed, followed instructions for medicines given when needed, and had their competence checked.
“People received their medicines as prescribed. We witnessed part of a medicine round and observed staff administering medicines to people consistently and safely.” from the report
Good risk management
Risk assessments were kept up to date and changes were made when people's circumstances changed. Incidents were reviewed and lessons were shared with staff.
“Records confirmed safety checks and maintenance work was carried out to make sure the premises and equipment were in safe working order.” from the report
Stronger leadership and oversight
The home had introduced a new management structure, regular audits and more support for staff. Inspectors found that concerns were identified and action was taken.
“These areas had improved immediately after that inspection and there were now robust premises and maintenance audits.” from the report
Registered manager vacancy
minorThere was no registered manager in post during the inspection. A new manager had started and planned to register, so families should check that this has been completed and that the management arrangements remain stable.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Has the new manager now registered with the CQC, and who is responsible for the home if the registration is not yet complete?
- 02How do you make sure staff can be found promptly when they are working in people's rooms along the long corridors?
- 03What checks now make sure carpets, cleaning and continence management remain effective?
- 04How are accidents, incidents and changes to people's risks shared with all staff?
- 05What are the current ratings and most recent findings for Effective, Caring and Responsive?
This was a focused inspection of Safe and Well-led, including infection prevention and control; Effective, Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 14 April 2023 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, January 2022
Requires Improvement; inspectors found kind care, but concerns about the environment, checks and leadership led to two breaches.
This was an unannounced inspection on 16 and 17 December 2021. Inspectors spoke with people, relatives, staff and other professionals. They observed care, checked medicines, reviewed care and staff records, and examined management systems.
People generally said they felt safe and well cared for. Inspectors saw calm, caring support and found staff had suitable training. Medicines were managed safely, and infection control arrangements were mostly in place.
However, there was a strong smell in an upstairs corridor. Checks on pressure-relieving mattresses were not recorded clearly. Recruitment records were incomplete, and the provider's systems had not acted on known problems. The overall rating fell from Good to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other key questions were not inspected during this visit, and their earlier ratings were used.
Kind and calm care
Inspectors saw staff supporting people with empathy and patience. Lunch support was described as pleasant and unrushed.
“Staff showed empathy, caring and patience during our observations of interactions.” from the report
People generally felt safe
People and relatives mostly said people felt safe and well cared for. Inspectors found no evidence that the reported staffing concerns had compromised people's safety.
“People said they felt safe and well cared for.” from the report
Medicines competence
Staff had been assessed as competent to give medicines, and inspectors saw medicines being given in a caring and supportive way.
“Staff had been assessed to ensure they were competent in the safe administration of medicines.” from the report
Infection control arrangements
Inspectors found the home looked clean and staff generally wore suitable protective equipment during the inspection.
“During our inspection visits staff were wearing appropriate personal protective equipment (PPE)” from the report
Strong odour
seriousA strong smell in the upstairs corridor created an unpleasant environment for people. CQC found the home had not acted promptly enough to address it.
“We found no evidence that people had been harmed however, systems were either not in place or robust enough to prevent strong odours in some part of the service.” from the report
Mattress checks
needs fixingRecords did not clearly show when and how pressure-relieving mattresses were checked. Incorrect settings could increase the risk of pressure damage.
“We recommend the service ensures it follows manufactures guidance and clearly documents when and how mattress setting are checked to prevent harm of the mattress being wrongly set.” from the report
Incomplete recruitment records
needs fixingSome staff files did not fully record employment histories and gaps. The provider was asked to improve its recruitment practice.
“Recruitment practices did not always ensure that new staff's full employment history and any gaps in employment were documented.” from the report
Pressure-relief patch records
needs fixingThe location and removal of pain-relief patches were not recorded consistently, and there was no check that patches stayed in place. A daily check was added during the inspection.
“The recording of the location of application of the patch and removal was seen to not be carried out consistently.” from the report
Staff culture and morale
needs fixingSome staff concerns suggested an inconsistent and non-inclusive culture. The provider had begun work on this, but inspectors said it was too early to know whether it had improved morale.
“Anonymous concerns received indicated the registered manager had not always promoted a positive and inclusive culture between all staff.” from the report
- 01What has been done to remove the strong odour in the upstairs corridor, and how is this now checked?
- 02How are pressure-relieving mattress settings checked and recorded for each person?
- 03How do you now check staff employment histories and gaps before people are recruited?
- 04What changes have been made to record pain-relief patches and check that they remain in place?
- 05What evidence can you show that staff morale, teamwork and leadership have improved since this inspection?
This was a focused inspection of Safe and Well-led prompted by concerns; the other key questions were not inspected and their previous ratings were used. This explanation was written from the published report of 25 January 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 Tyspane
4 rated inspections over 8 years: the service has held its Good rating throughout.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- January 2018Goodstayed GoodSafe: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
17 live-in carers within about an hour of Devon
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 £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
“She is such a warm and gentle person while being professional and competent at the same time.”
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
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.