HF Trust - Trelowen

About the service

HF Trust - Trelowen is a residential care home providing personal care to 5 people at the time of the inspection. The service can support up to 7 people.

People’s experience of using this service and what we found

Right Support

People were not supported in a well-maintained environment which supported their sensory needs. Although it had been identified that improvements to the environment were required there were no clear timescales in place.

Staff enabled people to access health and support in the community. Annual health checks were in place and other checks followed up.

Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.

People received their medicines as prescribed. These were not administered in a way that promoted people’s independence and protected their privacy.

People were supported to have choice and control in 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.

Right Care

Staff understood people’s individual needs and preferences. Where useful, communication tools were used to aid people’s understanding and choice making.

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Records relating to what people ate and drank and their weight were not reliable or informative.

Right Culture

Staff had received training in best practice. This was underpinned by a system of competency checks and observations of practice.

Staff knew and understood people well, there was a consistent staff team in place. When agency staff were used they were given the information they needed to support people according to their individual needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 12 October 2017).

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.

We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for HF Trust - Trelowen on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the environment and the management of the service.

Please see the action we have told the provider to take at the end of this report.

We have made a recommendation about the approach to supporting people with their medicines.

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.

HF Trust – Trelowen provides care and accommodation for up to seven people who have a learning disability. At the time of the inspection six people were living at the service. The service was last inspected in August 2015 when it was rated as Good. At this inspection we found the service remained Good.

There was a registered manager in post. 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 saw people and staff interacting and engaging with each other in a friendly and relaxed manner. Staff had completed training in how to recognise the signs of abuse. People received their medicines safely and as prescribed.

Staff were well supported by a system of induction, training and supervision. Training was refreshed regularly. Staff meetings were an opportunity to contribute to the running of the service. Staff told us they were well supported by the management team and each other.

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.

Information was produced using easy read techniques, e.g. limited text and photographs and pictures. People’s preferred communication styles were identified and respected. However, care plans were not available in an accessible format.

People were supported to understand systems for raising concerns. House meetings were held regularly. Staff encouraged people to use these to voice their ideas and suggestions.

There were clear lines of responsibility in place. The registered manager was supported by a senior support worker. People had been assigned key workers with responsibility for their day to day care. Relatives told us management were approachable and they would not hesitate to approach them with any concerns or suggestions they might have.

Further information is in the detailed findings below

We did not speak with anyone who lived at Trelowen due to their communication needs. We observed two people who were at home during the inspection and saw they appeared relaxed and at ease. Following the inspection we spoke with the registered manager.

This was a follow up inspection to check if improvements had been made in the area of non-compliance identified during the last inspection in August 2013.

We saw people's privacy and dignity was respected by the way staff supported people with their day to day needs.

We examined people's care files and found the records were up to date and reviewed as the person's needs/wishes changed.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We found the design and layout of the premises did not always promote people's well-being.

During our inspection we met seven people who lived at Trelowen. Comments included, I like being here', 'and I like being with the staff, and 'often go out places for lunch'.

One person we spoke to told us, 'some of the younger members of staff are bossy and don't understand what you're trying to say'.

Staff we spoke with told us,' we are very aware of what people like' and we do well at 'supporting seven people with very different needs'.

We found people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care and people experienced care, treatment and support that met their needs and protected their rights.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening and the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.