Archived: Truscott House

Updated 7 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 was a comprehensive inspection. The inspection took place on 20 July 2017 and was announced. We gave the provider 48 hours’ notice of the inspection to make sure someone was available in the office to meet with us. The inspection was carried out by one inspector.

Before our inspection we reviewed information we held about the service. This included statutory notifications received from the provider and the Provider Information Return (PIR). The PIR is a form we asked the provider to complete prior to our visit which gives us some key information about the service, including what the service does well, what the service could do better and improvements they plan to make.

During the inspection we spoke with four people using the service, one relative, the registered manager, seven care workers and the regional operations manager. We looked at a range of records including three staff files, five people’s care plans, records relating to medicines management and other records relating to the management of the service.

After the inspection we contacted a social worker who had recently audited the service who shared their report with us.

Updated 7 September 2017

This inspection took place on 20 July 2017 and was announced. We gave the registered manager 48 hours to make sure someone was available in the office to meet with us. This was the first inspection of the service following registration with CQC in February 2016.

Truscott House provides personal care for up to 37 people living in one bedroom flats in a supported living scheme of the same name. People had a range of needs including mental health and physical disabilities as well as dementia. There were 23 people using the service at the time of this inspection.

The home had a registered manager in post. 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.

There were not always enough staff deployed to meet people’s needs. In addition, the provider did not adequately always assess risks to people and ensure actions were taken to mitigate risks. This included risks relating to people’s medical and health needs. The provider did not always have care plans in place to inform staff about some people’s individual needs and how staff should care for people in relation to these. The provider did not always review people’s care plans when their needs changed to ensure care provided to them continued to meet their needs.

Medicines management was not always safe as we were unable to confirm people received medicines as prescribed. This was because the provider did not have systems in place to keep track of the quantities of medicines in stock. We were also unable to confirm medicines were disposed of safely as the provider did not keep disposal records.

Care was not always provided to people in line with the Mental Capacity Act (MCA) 2005. The provider had not always carried out mental capacity assessments regarding decisions relating to people’s care, such as those relating to medicines administration. In addition the provider had not taken action to assess whether people required constant supervision as part of keeping them safe, and had not arranged deprivation of liberty authorisations where these may have been required. The provider told us they would carry out mental capacity assessments, arrange best interests meetings to decide the best ways to care for people where necessary and also review whether people required deprivations of liberty authorisations to keep them safe.

The service was not always well-led. Although the provider had audits in place to monitor and assess the quality of service, these had not identified the issues we identified relating to staffing, risk assessments, care plans, medicines management and supporting people in line with the MCA.

People were cared for by staff who were recruited following robust checks of their suitability. Staff were well supported by the provider. A suitable programme of training and one to one supervision was in place to help staff understand people’s needs and carry out their roles. Staff felt well supported and the provider communicated with staff and had systems in place to gather their feedback on the service.

People felt safe and staff understood how to respond if they suspected anyone was being abused to keep them safe as they received training in relation to this from the provider.

People received the support they needed in relation to eating and drinking. The provider supported people to access the healthcare services where this was part of their care package.

People were supported by staff who were kind and caring and treated them with dignity and respect. People spoke positively about the staff who supported them. Staff knew the people they were supporting, including their preferences, health needs and backgrounds. People were supported to maintain their independence as far as possible.

The provider gathered feedback from people on the quality of service in various ways and people felt confident if they complained the registered manager would take this seriously and respond appropriately.

We found breaches of the regulations relating to staffing, safe care and treatment, consent and good governance. You can see what action we have asked the provider to take to address these breaches at the back of this report.