Archived: OSJCT Trevone House

Updated 3 February 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 13, 14 and 15 December 2017. It was carried out by one inspector and was unannounced. Before a visit to the home we reviewed the information we held about it. This included information which had been shared with us since the last inspection on 21 February 2017 and statutory notifications. These notifications contain information about incidents and events which have taken place which the provider must legally make us aware of. Prior to this inspection we did not request a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Instead we gathered this information during the inspection.

During the inspection visit we spoke with and gathered the views of six people who lived at Trevone House, including those of three relatives and one friend. We inspected six people’s care files which included pre-admission assessments, care plans, risk assessments and other relevant records. We reviewed four people’s repositioning and food and fluid intake charts. We also reviewed records and documents relating to the care of three people under the Mental Capacity Act 2005 and who had authorised Deprivation of Liberty Safeguards. We spoke with the registered manager, deputy manager, operations manager and regional operations director. We also spoke with one registered nurse, head chef, activities co-ordinator, maintenance person, two housekeepers, two care assistants (one day and one night) and two care leaders.

We looked at other records related to the management of the home. These included three staff recruitment files, the staff training record, a selection of audits and one action plan. We reviewed the maintenance records and various service certificates. We read the minutes of a staff meeting and those of reflective meetings held with staff. We reviewed the information made available to people in the reception area and on designated noticeboards. We attended two staff handover meetings. We visited all areas, inside and outside of the building, which were accessible to people.

Updated 3 February 2018

This inspection took place on 13, 14 and 15 December 2017 and was unannounced.

During a comprehensive inspection on 1, 2 and 3 June 2016 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Regulation 9 Person centred care and Regulation 17 Good Governance. We asked the provider to complete an action plan to show us what they would do and by when to improve the key questions “safe, effective, responsive and well-led” to at least good. They told us these would be addressed by 31 December 2016 to, ensure people’s care and treatment was delivered in such a way which would meet their individual preferences and choices and to ensure accurate and relevant care records were maintained.

We undertook an unannounced focused inspection of Trevone House on 21 February 2017. This inspection was done to check that the above legal requirements, and improvements, planned by the provider, had been completed. During this focussed inspection the service was inspected against the key questions “safe, effective and well-led”. At this inspection we found the provider was compliant with the prior breaches of Regulation. However, a period of consistent and sustained improvement was required and the rating remained at Requires Improvement.

At this comprehensive inspection completed on 13, 14 and 15 December 2017 we found the service had sustained the improvements we found in February 2017 and this inspection therefore rated the service as Good overall.

Trevone House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Trevone House accommodates 47 older people in one adapted building. At the time of the inspection there were 31 people living there.

People are provided with a single occupancy bedroom. Each room has a sink, bedroom furniture and necessary equipment, a window and radiator. Additional communal toilets, bathrooms and rooms to sit and eat in are provided. The accommodation is across two floors; the second floor accessed by stairs or a passenger lift. There is a garden at the front of the home and off road car parking is available near to the building.

A registered manager was in place. 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.

Arrangements were in place to keep people safe from potential abuse, discrimination and risks which could have a negative impact on their well-being. Staffing requirements were monitored and had been adjusted to ensure people’s needs could be met safely. People’s medicines were managed in such a way which ensured they received as prescribed and needed. People lived in a clean environment where there were measures were taken to prevent and minimise the impact of infection. Staff worked with other health care professionals to ensure people’s health needs were both assessed and met. Risks to people’s health were identified and managed.

People’s consent to be cared for and treated was sought. 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. Where people could not provide consent and make independent decisions about their care and treatment, the principles of the Mental Capacity Act 2005 were adhered to in order to protect them. People were lawfully deprived of their liberty where this was needed to keep them safe and in receipt of the care they required.

People and those who mattered to them were cared for in a compassionate way. Staff supported people in a personalised way to ensure their specific and diverse needs were met. People privacy, dignity and rights were upheld. People were supported to be as independent as possible. People’s care was planned with them and where appropriate, their relatives or representatives could speak on their behalf. Complaints and any areas of dissatisfaction were taken seriously and addressed. People’s end of life wishes were explored with them and advanced care planning ensured these were met at the appropriate time. Staff were experienced and trained to meet people’s end of life needs. Staff were supported by other health care professionals who worked together to ensure a person’s death was dignified and pain free.

The registered manager had provided strong and consistent leadership since being responsible for the management of the home. They had made changes to how the home was run and its culture. Subsequently a far more open and supportive atmosphere existed. People and staff felt able to raise any concerns and they were confident these would be looked at and addressed. Effective communication existed between staff groups and people. Staff and management were working together to improve services for people. Effective monitoring of the service ensured it remained compliant with necessary regulations and continued to improve.