Archived: Tristford

Updated 13 December 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 inspection took place on 2 November 2017 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.

To plan the inspection we used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make We reviewed notifications we had received from the service. Notifications are information we receive from the service when significant events happen, like a serious injury.

During our inspection we spoke with nine people living at the service, the provider, the registered manager, five care staff and the chef. We visited people’s bedrooms, with their permission; we looked at care records and associated risk assessments for three people. We also looked at staff duty rosters, training records, four recruitment files, health and safety checks for the building minutes of staff and residents meetings and policies and procedures relating to the service delivery and management. We observed the care and support people received. We looked at their medicines records and observed people receiving their medicines.

Some people were unable to tell us about their experience of care at the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

This was the first inspection since the provider for Tristford changed its legal entity in December 2016.

Updated 13 December 2017

Tristford is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Tristford accommodates 12 people in one adapted building. Accommodation is arranged over two floors and there is a lift to assist people to get to the upper floor. There were 12 people with a physical disability living at Tristford at the time of our inspection. The building was clean and well maintained. Equipment was checked regularly to make sure it was safe.

The registered manager was leading the service and was supported by a deputy manager. 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.

Some people told us they would like to go out more often and additional staff were being recruited to support people. Other people told us they had enough to do during the day, including taking part in activities they had enjoyed. This was an area for improvement.

Staff were kind and caring to people and treated them with dignity and respect at all times. People told us staff gave them privacy and knocked before entering their bedrooms. Everyone was supported to be as independent as they wanted to be. People received care in the way they preferred at the end of their life from staff and health professionals.

People were not discriminated against and received care tailored to them. Assessments of people’s needs and any risks had been completed. Each person had planned their care and support with staff to meet their needs and preferences, including taking risks when they wanted to. No two people received the same support. Staff supported people to tell other professionals involved in their care, such as the multidisciplinary team, about their needs and wishes and helped them follow any advice and guidance given. Accidents and incidents had been analysed and action had been taken to stop them happening again.

Changes in people’s health were identified quickly and staff supported people to contact their health care professionals. People’s medicines were managed safely and people received their medicines in the ways they preferred and as their healthcare professional had prescribed. People were offered a balanced diet and were involved in planning the menus. Staff helped people who needed support at mealtimes to have as much independence as they wanted.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager knew when assessments of people’s capacity to make decisions were needed. Staff assumed people had capacity and respected the decisions they made. When people needed help to make a particular decision staff helped them. Decisions were made in people’s best interests with people who knew them well. The registered manager understood their responsibilities under Deprivation of Liberty Safeguards (DoLS), and had checked to make sure no one was deprived of their liberty.

Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager and provider. Complaints were investigated and responded to.

There were enough staff to provide the care and support people needed when they wanted it. Staff were recruited safely and Disclosure and Barring Service (DBS) criminal records checks had been completed. Staff were supported meet people’s needs and had completed the training they needed to fulfil their role. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.

The provider and registered manager had oversight of the service. They checked all areas of the service met the standards they required. Staff felt supported by the registered manager and deputy manager, they were motivated and enthusiastic about their roles. A manager was always available to provide the support and guidance staff needed. Staff worked together to support people to be as independent as they wanted to be. Records in respect of each person were accurate and complete and stored securely.

Services that provide health and social care to people are required to inform the CQC, of important events that happen in the service like a serious injury or deprivation of liberty safeguards authorisation. This is so we can check that appropriate action had been taken. We had been notified of all significant events at the service.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating under their previous legal entity in the entrance hall of the service and on their website.