Archived: Trengrouse

Updated 13 April 2021

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.

As part of CQC’s response to care homes who had been in outbreak of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 22 March 2021 and was announced.

Updated 13 April 2021

We carried out this unannounced comprehensive inspection on the 12 April 2018 after receiving concerns that people were not receiving the care and support they needed. There was a high use of agency staff and that the service lacked leadership and direction. Following this inspection it was judged these allegations were not substantiated. The last comprehensive inspection took place on the 28 February 2017. The service was meeting the requirements of the regulations at that time.

Trengrouse is a ‘care home’ that provides nursing care for a maximum of 41 adults, with a range of health care needs including dementia, nursing and mental health. At the time of the inspection there were 36 people living at the service. 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.

Trengrouse is situated in the town of Helston. It is a purpose built single storey building with a range of aids and adaptation in place to meet the needs of people living there. It is close to the centre of Helston with links to public transport. There are three separate lounges radiating from a central hub, with peoples rooms leading off from the various lounge areas. All rooms were single occupancy. There was a main dining room but also small dining areas in each lounge. There were a range of bathing facilities in each area designed to meet the needs of the people using the service. There was a central patio area and a garden which people could use if they were being supported.

Risks in relation to people’s daily lives were identified, assessed and planned to minimise the possibility of harm whilst helping people to be as independent as possible. Records included evidence of reviews to make sure changes were being monitored and responded to. Care plans included information about people’s general health and who was involved in the person’s care and welfare.

Some people’s health needs meant they needed to have their food and drink intake monitored to ensure they received sufficient each day. We found the records for monitoring were not always complete. Three records recording people’s food and fluid intake on a daily basis did not include the amount expected on a daily basis. This was recorded in the main care file but had not been applied to the records used by staff. This meant staff were not reminded of the daily amount required which had the potential to affect their judgements. We have made a recommendation about this.

People received care and support that was responsive to their needs because staff had the information to support them. Staff supported people to access healthcare services. These included, social workers, psychiatrists, general practitioners (GP) and speech and language therapists (SALT). Relatives told us the service always kept them informed of any changes to people’s health and when healthcare appointments had been made.

There were sufficient numbers of suitably qualified staff on duty to meet people’s needs and there was less reliance on agency staff to ensure people were familiar with those staff providing care and support.

The way medicines were managed was safe. Staff responsible for the administration of medicines had the necessary competency and skills required. Medicines were stored securely and safely.

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. There was a wide range of training available to all staff which met the diverse needs of people being supported. Staff were supported through formal supervision.

Staff were supported by the registered manager through regular updates called ‘stand up meetings’. These kept the staff team up to date with any changes and provide any essential information that might be needed to be shared to support peoples care and welfare.

Some areas of the environment required attention. For example some chairs had cushions missing, one chair was heavily stained and a table in the lounge area had no chairs around it and therefore restricted people using this area for some time until one was replaced. We spoke with the registered manager about this and were provided with a maintenance plan for the year which identified when furniture and decoration would be taking place.

Infection control measures were in place. Where people were at high risk of infection staff were knowledgeable about the risk and action to be taken. There was a housekeeping team who told us they had the training and equipment to keep the service clean and understood key issues for infection control. However there was an underlying odour in parts of the service. We shared this information with the registered manager. They told us action was being taken to remove the odour by replacing carpets in some rooms with cushion floor. All staff had infection control training as part of their induction. They then undertook refresher on-line training. A new in-house infection control course is being planned, to reflect the particular needs of people using the service.

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

The manager used effective systems to record and report on, accidents and incidents and take action when required.

There was a system in place for receiving and investigating complaints. People we spoke with had been given information on how to make a complaint and felt confident any concerns raised would be dealt with to their satisfaction.

People told us the registered manager and the staff team were approachable, friendly and supportive.

The provider had systems in place to monitor the quality and safety of the service.