We carried out an unannounced inspection on 28 June 2012. On the day of our visit there were 39 people living at Trelana. The inspection team was led by a CQC inspector and was joined by an "expert by experience"; this is somebody who had experience of using services and who would provide that perspective.
We spoke with or observed fifteen people who live in the home and four regular visitors. We spoke with the company representative, the clinical lead nurse and six other staff.
We made a partial tour of the premises. We saw that on the lower ground floor there were displays that people could touch with furry and sequinned pictures, also objects of interest at intervals along the corridor. There were plenty of pictures and mementos of the recent jubilee celebrations. These were there to stimulate people's interest and help them find their way around the home.
There were several display boards with photos showing people who live in the home and their relatives engaging in recent activities in the home.
People were well dressed, clean, and comfortable in their surroundings. Staff told us they were able to be flexible about the time they helped people to get up and dressed in the mornings.
We saw lunch being served. One person told us they had complained because 'pasta bake had been served every day for tea', and now they get something different.
People were anxious because some staff had recently left and they knew that some more staff were due to leave soon. Regular visitors to the home told us they thought that staff who worked regularly in the home were 'Brilliant' but they were not so happy with agency staff who did not know people well.
We looked at care records and found that they were maintained to a safe standard but there was insufficient evidence of consultation and personal preferences.
There were significant gaps in training provided, so staff lacked updates in vital areas, and lacked specialist training in dementia care. This may mean that people with dementia may not have the specialist support they need.
We looked at staff rotas. We found that a safe level of staffing was maintained by the use of agency staff. An arrangement had been made with an agency so that the same staff would be provided consistently, to become familiar with people living in the home and their care needs. Recruitment was on-going at the time of this visit, with new care and nursing staff due to commence employment. There was no manager in post and the recruitment process had started. Some staff said they felt low morale because of the lack of stability in the team, and some said they felt undervalued by the company. European Care were responsible for management support. Though there was a business services manager who often worked at Trelana, three different regional managers had supported the home over the months of May to July 2012. This did not contribute to stable management.