Archived: The Tynings

The Tynings has been developed and designed in line with the values that underpin the Registering the Right Support, Building the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People’s care was individualised reflecting their backgrounds, likes and dislikes and aspirations. They were involved in the planning of their care and had the opportunity to talk with staff about their care and support. Their diversity was recognised and their human rights were respected. They were provided with accessible information which used pictures and photographs to illustrate the text. Staff promoted communication through a range of strategies and resources to enable people to express their views and feelings. People occasionally became unsettled or anxious. Staff supported them to cope with these emotions effectively following their care records. Staff knew people well and recognised the importance of good communication to ensure continuity of care and support.

People were kept safe from harm. Risks were minimised whilst encouraging people to be as independent as possible. People were supported to learn the skills to live more independently and helped out around their home. They had access to a wide range of activities both at home and in the community. They had individual support when needed to participate in activities such as the cinema or concerts. People were supported to stay healthy and well. They had access to health care professionals and were supported to attend appointments. The registered manager was working closely with health care professionals to ensure all people had access to the support they needed. People’s medicines were safely administered and people were helped to manage their own medicines if they wished. People’s dietary needs were considered and special diets provided.

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. People whose liberty was restricted had the necessary safeguards in place. People made choices about their day to day lives. Best interest meetings were held when people were unable to make decisions about aspects of their care.

People were supported by staff who had access to training to equip them with the skills to meet their needs. A satisfactory recruitment process was in place to make sure staff had the right character and skills. Staff were confident raising concerns and found the registered manager to be open and accessible. Staff levels reflected the needs of people and were reviewed as people’s needs changed.

People’s views and those of their relatives and staff were sought as part of the quality assurance process. A range of audits and checks were completed to monitor the quality of service provided and make sure a safe environment was maintained. The provider and their representatives visited the home and carried out their own quality assurance audits. The registered manager felt supported and kept up to date with changes in legislation and best practice.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection of this service on 24 June 2015. A breach of a legal requirement was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirement in relation to Regulation 9 Person centred care.

We undertook this unannounced focused inspection on 17 May 2017 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Tynings on our website at www.cqc.org.uk.

The Tynings is a care home for up to six people with a mild to moderate learning disability, autism or sensory impairment. Six people were accommodated when we completed this inspection.

People were now supported by relevant healthcare professionals to maintain their health and wellbeing. We have made a recommendation about healthcare professionals completing mental capacity assessments for specific medical conditions and their treatment and monitoring.

At the time of our inspection visit The Tynings had a registered manager in post who was on special leave and the assistant manager was in charge supported by the provider’s representative. 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.

We found the provider had reviewed the care plans for all the people who used the service. Where necessary, staff had completed body charts correctly and investigations had taken place and documented. We checked people's medicines charts for July, August and September and found them to have been completed correctly. We could not check full compliance for the new recruitment practices because there had been no new member of staff employed since our last inspection.

The provider had completed the actions plans produced in response to our last inspection. We found the provider to be compliant with outcomes previously found to be non-compliant.

In one person's care file we found body charts had been completed. These charts showed that the person had sustained several injuries that could not be explained. The staff had not made any notes about these injuries in the daily notes. There was no evidence that any investigation had taken place to establish how the injuries happened.

Whilst staff had been trained to safely administer people's medicines, we found gaps in recording on the medication charts and issues regarding administration and disposal of medicines, that gave us cause for concern.

We saw evidence that recruitment procedures had not been effective and that people were not always cared for, or supported by, suitably skilled and experienced or appropriate staff.

The provider's quality monitoring process was not effective and had not picked up all the areas of concern we identified during our inspection visit.

We found that the home was nicely decorated and the layout suited the needs of the people who live there. However we found that some required home maintenance checks had not been completed in recent years. People were happy with the care and support they received from staff but we were concerned that not all appropriate checks had been completed before staff started working with people.

A 'service user council' ran monthly and this was valued by those that attended. One person said 'It's brilliant, you feel like you can say anything you want and can let off steam'. They felt that the council 'made a difference' as when they had raised issues these had been acted upon.