This unannounced inspection was carried out on 07 February 2018. During our last inspection in July 2017 we rated the service as requires improvement. Following this inspection the rating remains requires improvement. This was because, although we saw improvements had been made following the last inspection, these improvements have not yet been fully embedded within the culture of the service. We also found some additional aspects of the service which required action before the service could be rated as good. Trembaths is a ‘care home with nursing’. 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.
Trembaths accommodates up to 51 people in one adapted building across two separate units, each of which have separate adapted facilities. One unit is for people with nursing needs and the second is for people with residential needs including people who live with dementia. At the time of the inspection there were 41 people living at the home.
Since the last inspection the registered manager had left the service and one of the provider’s area support managers was acting into the role until such time as a permanent manager was recruited. The area support manager (acting manager) had commenced the process to register. 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.
Following the last inspection, we met with the provider to confirm what they would do and by when to improve the key questions Safe, and Well led to at least good. A condition was placed on the provider’s registration requiring them to provide monthly reports on their progress towards meeting the required standards. The provider also submitted an action plan showing what action they would take and by when to address the concerns identified at the inspection.
This inspection was done to check that improvements to meet legal requirements planned by the provider after our July 2017 inspection had been made. The team inspected the service against two of the five questions we ask about services: Is the service well led, and is the service safe? This is because the service was not meeting some legal requirements within these two questions.
No risks or concerns were identified in the remaining key questions through our ongoing monitoring or during our inspection activity, so we did not inspect them. The ratings from the previous comprehensive inspection for these key questions were included in calculating the overall rating in this inspection
There were systems and processes in place to safeguard people from harm, and incidents were reported appropriately. When mistakes were made by the provider or staff, these were acted on, lessons were learned and improvements were made.
The provider had policies and systems in place to protect people from the risk of infection. However, some staff did not always follow good practice in relation to infection control.
Medicines were not always managed safely. The provider was aware of this and was taking appropriate steps to improve this and reduce the risk of harm to people.
There were sufficient staff to support people safely although the way in which work was organised sometimes resulted in delays in meeting people’s needs. The provider had effective recruitment processes in place.
There were risk assessments in place that gave guidance to staff on how risks to people could be minimised and these were regularly reviewed and updated when people’s needs changed.
The provider encouraged feedback from people and acted on the comments received to continually improve the quality of the service.
The provider had a clearly defined set of values to underpin the service and these were known and understood by staff. The acting manager was prioritising the development of a more person centred culture within the service.
The provider now had effective quality monitoring processes in place to ensure they were meeting the required standards of care
Notifications were sent to the Care Quality Commission as required by law.
You can see what action we told the provider to take at the back of the full version of the report.