Archived: Tilford Park Nursing Home

Updated 26 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 01 August 2016 and was unannounced. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the completed PIR and we checked information that we held about the service and the service provider. This included statutory notifications sent to us by the provider about incidents and events that had occurred at the home. A notification is information about important events which the provider is required to tell us about by law. We used all this information to decide which areas to focus on during our inspection.

We spoke with 11 people who lived at Tilford Park Nursing Home and five relatives. We also spoke with two nurses, a team leader, two care staff and the registered manager.

All apart from two people at the home were living with dementia and we were unable to hold detailed conversations with many of them. In order to understand their experiences of living at the home we spent time observing the care and support that people received in the lounges and communal areas of the home during the morning, at lunchtime and during the afternoon. We also observed part of the medicines round that was being completed.

We reviewed a range of records about people’s care and how the home was managed. These included care records and medicine administration record (MAR) sheets for seven people and other records relating to the management of the home. These included staff training, support and employment records, quality assurance reports, policies and procedures, menus and accident and incident reports.

Tilford Park Nursing Home was last inspected on 30 May 2014 when no concerns were identified.

Updated 26 August 2016

Tilford Park Nursing Home provides nursing care and accommodation for a maximum of 42 older people who may be living with dementia. At the time of this inspection there were 38 people living at the home, all apart from two who were living with dementia.

This was an unannounced inspection which took place on 01 August 2016.

During our inspection the registered manager was present. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they felt safe in the home. However, staffing levels did not ensure that people who lived with dementia received all the support they required at the times they needed. We observed that staff were rushed and had little time to spend with people outside of delivering care to them. You can see what action we told the provider to take at the back of the full version of the report.

Staff had some understanding of the Mental Capacity Act 2005 (MCA) and of the Deprivation of Liberty Safeguards (DoLS) and had received training in these areas. People’s representatives had not always been involved in decision making processes when people lacked capacity to consent to ensure their rights were upheld. You can see what action we told the provider to take at the back of the full version of the report.

People said they were happy and comfortable with their rooms and we saw that they were attractively decorated with some personal touches including photographs and memorabilia. However, some elements of the environment didn’t lend themselves to assisting the needs of people with dementia. We have made a recommendation about this in the main body of our report.

Staff said that they received sufficient support and training to fulfil their roles and responsibilities. Training was provided during induction and then on an on-going basis. A training programme was in place that included courses that were relevant to the needs of people who lived at Tilford Park Nursing Home. However, at times some staff did not demonstrate sufficient understanding when supporting people who lived with dementia. We have made a recommendation about this in the main body of our report.

Everyone that we spoke with said that the manager was a good role model. Quality monitoring systems were in place that included seeking the views of people in order to drive improvements at the home. Checks were not always completed in line with the provider's policy and action plans were not always recorded to improve identified shortfalls. We have made a recommendation about this in the main body of our report.

Potential risks to people were assessed and information was available for staff which helped keep people safe. However, at times staff restricted people’s movements without a clear rationale being in place. We have made a recommendation about this in the main body of our report.

People said that in the main they were happy with the choice of activities on offer and that they were supported to maintain links with people who were important to them. Access to further stimulation would enhance people’s wellbeing further. We have made a recommendation about this in the main body of our report.

People were treated with kindness and compassion. Although we observed that staff at times appeared busy and rushed we saw no signs of impatience with people. Staff appeared dedicated and committed. We observed that care was given with respect and kindness but it was clear that some people had to wait for too long for the help they required.

Robust recruitment checks were completed to ensure permanent staff were safe to support people.

People said that they were happy with the medical care and attention they received and we found that people’s health needs and medicines were managed effectively. People’s needs were assessed and care and treatment was planned and delivered to reflect their individual care plan.

People said that the food at the home was good and that their dietary needs were met. There were a variety of choices available to people at all mealtimes.

Equipment was available in sufficient quantities and used where needed to ensure that people were moved safely and staff were able to describe safe moving and handling techniques.

Information of what to do in the event of needing to make a complaint was displayed in the home. During our visit we observed staff assessing if people were happy as part of everyday routines that were taking place.