Archived: Tavistock Square

Updated 20 April 2015

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.

We inspected 17 Tavistock Square on the 23 and 28 October 2014. The provider was given 48 hours’ notice because the location was a small care home for younger adults who are often out during the day; and we needed to be sure that someone would be in.

The inspection was led by an adult social care inspector and a specialist advisor with experience of learning disability services. Before we visited the home we checked the information that we held about the service and the service provider. No concerns had been raised and the service met the regulations we inspected against at their last inspection which took place on 30 July 2013.

Some people we spoke with were unable to communicate verbally with us whether they felt safe living at the home. However when prompted by staff we saw how people displayed non-verbal signs by smiling and gesturing with their hands. We reviewed three care records, shift rotas, staff training records, and records relating to the management of the service such as audits.

During our inspection we looked at the care and medication records for five people and observed how the staff interacted with people who used 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. We observed people during the lunchtime meal in the dining room. We spoke with the registered manager, the deputy manager and four care workers.

We contacted healthcare professionals involved in caring for people who used the service, including social workers, and a clinical psychologist. We also spoke with three family members following our visit, and they provided positive feedback regarding the services provided at the home.

Updated 20 April 2015

The inspection took place on 22 and 26 October 2014. The inspection was a short notice visit, which meant the staff were informed 48 hours previously we would be visiting. We last inspected Tavistock Care Home in July 2013. At that inspection we found the home was meeting all the regulations that we inspected.

Tavistock Square provides accommodation and personal care only, for up to six adults who have a learning disability. It is located in Sunderland, close to amenities and with good transport links.

There was a registered manager at the service at the time of our inspection. We were informed during our visit how the current manager intends to transfer to another location within the company. Arrangements were already in place for the deputy manager to become the registered manager and they were waiting for approval from The Care Quality Commission (CQC). 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 we spoke with were unable to communicate verbally with us whether they felt safe living at the home. However they did display non-verbal signs when prompted by staff by smiling and gesturing with their arms Family members did confirm to us that they felt their relative was safe. Their comments included, “The staff are wonderful”; “They have worked wonders and worked very hard”, and, “I am over the moon how settled [my relative] is”.

Staff undertook risk assessments where required and people were routinely assessed against a range of potential risks, such as when using the mini bus, public transport and mobility.

Staff we spoke with had a good understanding of safeguarding and the provider’s whistle blowing procedure. They also knew how to report any concerns they had. The provider had a system in place to log and investigate any safeguarding concerns made known to them. However our records showed no statutory notifications including safeguarding concerns had been reported to the CQC. This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The submission of notifications is important to meet the requirements of the law and enable us to monitor any trends or concerns We have dealt with this separately outside of the inspection process

Staff had a good understanding of how to manage people’s behaviours that challenged the service and had developed interventions and strategies to help them manage people’s behaviours that were considered challenging.

People had their needs assessed and the assessments had been used to develop person centred care plans. Care plans had been evaluated regularly each month. Where people’s needs had changed action was taken to keep them safe.

Family members of people who used the service and staff all told us they felt there were enough staff to meet people’s needs. The registered manager monitored staffing levels to ensure there was sufficient care and support staff available to meet people’s needs.

Staff were supported to carry out their caring role and received the training they needed. Training records confirmed that staff training was up to date at the time of our inspection.

Staff followed the requirements of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS). MCA assessments and ‘best interests’ decisions had been made where there were doubts about a person’s capacity to make a specific decision. The registered manager had also made DoLS applications to the local authority where required.

We observed over the lunch-time that staff made sure people were safe and had support if they needed it. We also observed that staff interaction with people was warm, kind and caring. We saw staff preparing lunch and supporting people in the communal kitchen /dining area and were provided with meals which they preferred and had requested.

People were supported to maintain their healthcare needs. Family members told us that staff provided support to their relative to attend health appointments. Another said, “They look after my relative’s needs and keep me informed if there are any concerns.”. Other family members said, “I visited the home the other evening and I was told how [my relative] had enjoyed his recent holiday with members of the staff team.”

The home’s complaints procedure was available in different formats. None of the people or family members we spoke with had made a complaint about the care they received.

There was regular consultation with people and family members via the carer’s forums and their views were used to improve the service.

The provider undertook a range of audits to check on the quality of care provided. Some gaps were noted in the medicines records and the manager and her deputy had carried out an investigation to determine the cause. Care staff responsible for medicines administration and auditing of records will be provided with feedback from their investigation. Information was analysed to look for trends and patterns and to identify learning to improve the quality of the care provided.