3 April 2018
During a routine inspection
At the last inspection in October 2015, the service was rated Good .
At this inspection we found evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. However we have made recommendations for the registered manager to improve medication procedures and ensure infection control systems improved. In addition we have recommended the provider develops a programme of refurbishment. This was so people were kept safe and lived in a healthy environment.
This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Tylecote is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, both of which we looked at during this inspection.
A registered manager was in place. 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 using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns.
People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people's safety, and balanced these against people's rights to take risks and remain independent.
Safe recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed.
We found PRN (as required) medicines were not stored correctly and some were missing lables, making it difficult to be sure who the medicine belonged to.
We have made a recommendation about safe medicine procedures.
Infection control measures were in place however these were not always adhered to. The kitchen was in need of some refurbishment and cleaning and parts of the communal areas also needed attention. However during the inspection visit this was being addressed. We have made recommendations in relation to infection control and refurbishment of the environment.
Any accidents/incidents or errors had been used as a learning opportunity.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice
Staff received an induction process and on-going training. They had attended a variety of training to ensure that they were able to provide care based on current practice when supporting people.
People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.
People’s care and support had been planned with them. They told us they had been consulted and listened to about how their care would be delivered.
Care plans were organised and had identified care and support people required. We found they were informative about care people had received.
People were supported to access a variety of health professionals when required, including opticians and doctors to make sure that they received additional healthcare to meet their needs.
Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.
In order that people could maximise their opportunities and have their views heard the registered manager worked closely with the advocacy service to support people and to ensure they were not disadvantaged.
People's privacy and dignity was maintained at all times. Care plans were written in a person centred way and were responsive to people's needs. People were supported to follow their interests and join in activities.
Sufficient staff were on duty to meet people's needs. People told us staff responded quickly when they needed assistance. Throughout our inspection we observed there was a visible staff presence at all times.
People knew how to complain. There was a complaints procedure in place and accessible to all. No recent complaints had been received.
Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.
Further information is in the detailed findings below.