Tamarisk

Updated 17 August 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.

We carried out a comprehensive inspection on 13th June. It was unannounced and carried out by two inspectors.

Before the inspection we had reviewed information we already held about this service. This included details from the provider on a Provider Information Return (PIR). This form gave us key information about the service, and told us what the service does well and what improvements they were planning to make.

We also looked at previous inspections and any statutory notifications sent to us (notifications are information we receive when a significant event happens, like a death or serious injury).

During the inspection we looked at a range of information including three care plans, the staff training matrix, staffing rotas, recruitment files, minutes from staff meetings, internal audits, health and safety records and staff supervision and appraisal records.

We spoke to the registered manager and three members of staff. People were unable to give us their views about the service. We have tried to represent people’s ‘voices’ through our observations during the inspection and feedback from professionals and families.

Following the inspection, the provider sent copies of documents that we had requested including, results from quality questionnaires and a copy of the service and business plan.

Updated 17 August 2018

This was a comprehensive inspection which took place on 13th June 2018 and was unannounced. A previous inspection carried out in May 2016 did not identify any concerns.

Tamarisk is a care home. 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.

Tamarisk accommodates people with a learning disability and some with complex needs. At the time of our inspection there were 3 people at the service.

The service also provides personal care support for a further five people living independently in the community. This inspection will focus on all eight-people receiving the regulated activity of personal care.

The premises are set in a quiet residential road on the outskirts of Greatstone. There is access to local shops including a pub, hairdressers and newsagents and the beach within walking distance. The service has three bedrooms, a wet room, lounge and kitchen and spacious rear garden.

The care service has been developed and designed in line with the values that underpin the Registering 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 ongoing 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.

Why the service is rated good.

People were protected from abuse and the service had safeguarding procedures that staff understood. Individual risk assessments provided staff with the information they needed to reduce and manage risks whilst ensuring people’s individuality was respected.

There were sufficient numbers of trained staff to meet people’s needs and staff rostering allowed flexibility to ensure that staff could support people’s activities and appointments. Staff felt supported and received regular training and supervision. Robust staff recruitment procedures included statutory checks, induction training and mentoring by experienced staff, prior to starting work.

People received their medicines from trained staff and medicines were stored and recorded safely.

People’s individual needs were met through the design of the building. The service was clean, and people were protected from cross contamination and infection. Incidents had been recorded appropriately with systems for follow up and learning in place.

People’s needs had been assessed and were reviewed to reflect their choices and wishes and their support plans gave staff the information they needed to provide effective care in line with best practice and legislation.

People were supported to eat and drink to maintain a balanced diet and stay in good health and their consent was sought about day to day issues such as what they ate and drank.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Advocates were available to ensure that the provider worked in line with the principles of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). DoLS applications had been submitted appropriately.

People had access to routine health care with follow up referrals made to health and social care professionals as required.

People were happy and relaxed with staff and had been supported to express their views. The staff team were long standing members who knew the people well and treated them with kindness and dignity. The staff team had worked hard with other professionals to ensure that people could communicate through non-verbal means.

People had continued to receive responsive care and support that met their individual needs, took account of their choices and respected their wishes. Care plans contained ‘all about me’ documents that provided clear pen-portraits for each person and highlighted the body language people used to express themselves. The documents were written in a factual, respectful manner and were reviewed quarterly.

Staff encouraged people to engage in a range of activities and there were details of places they enjoyed visiting, with photographs of their daily activities and people were supported to maintain strong ties with relatives.

The service had complaints forms and a complaints procedure in place. Staff understood when people were unhappy and supported them to resolve any concerns and issues.

People’s end of life wishes had been discussed and agreed with support from families.

The Registered Manager had an open-door policy and worked hard to support staff on a day to day basis. Staff told us, “I can go to the Registered Manager with anything they are a good boss.” The registered provider had a range of quality monitoring processes and regularly sought the views of relatives and professionals to inform the development of the service.

Further information is in the detailed findings below.