24 November 2022
During a routine inspection
Trewan House Care Home is a residential care home providing personal care and accommodation for up to 44 people. The service provides support to older people and people who are living with Dementia in one adapted building. At the time of our inspection there were 42 people living at the home.
People’s experience of using this service and what we found
Medicines were not always managed safely. People did not always receive their prescribed medicines at the right times and some medicines were administered too close together, increasing the risk of overdose. The registered manager made immediate improvements to the safety of medicines during the inspection.
Risks to people's health, safety and wellbeing were not always safely managed. Staff did not always have access to information about how to manage people's identified risks and support them safely. The provider was in the process of moving care records to an electronic system which would support improvements in care plans and with oversight of these. However, care plans remained insufficient to guide staff on supporting people safely whilst this transition was implemented. The registered manager updated some care records during the inspection, and on day 2 we were assured about the safety of these care plans. An action plan was put in place to ensure all records could be updated in a timely manner.
Governance processes were in place and the registered manager and provider had oversight of essential aspects of the service. However, these processes were not always used effectively and some issues we identified at this inspection, such as medicines, had not been identified by the providers checks.
People were supported by kind and caring staff who treated people as individuals and with dignity and respect. Staff spoke knowledgeably about the systems in place to safeguard people from abuse. Infection control measures were in place to prevent cross infection. Staff wore appropriate PPE and the home was clean throughout. Visiting was safe and followed current guidance.
The support required by people with nutritional needs was identified and provided. People told us the chef was happy to cook other food if they did not like something on the menu.
Staff knew people well and people received care and support which was responsive to their needs. People’s choices regarding their care and how they were supported were respected, and there were enough staff to support this. We raised concerns about staffing levels on day 1, but the provider and registered manager made immediate changes to the staff rota and staffing levels were much improved on day 2.
People and family members knew how to complain, and they were confident about complaining if they needed to. Complaints were used to improve the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The management of the home promoted a person-centred service. There was an open and transparent culture and good partnership working with others.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 9 June 2021 and this is the first inspection.
The last rating for the service under the previous provider was good, published on 9 February 2021.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.