Random inspection report
Care homes for older people
Name: Address: Tregolls Manor Tregolls Road Truro Cornwall TR1 1XQ two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Diana Penrose Date: 2 5 0 6 2 0 0 9 Information about the care home
Name of care home: Address: Tregolls Manor Tregolls Road Truro Cornwall TR1 1XQ 01872223330 01872225412 tregolls.manor@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Tregolls Manor Homes Limited care home 25 Number of places (if applicable): Under 65 Over 65 25 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 Tregolls Manor is a detached property set off one of the main routes out of Truro and occupies an elevated position. There is level access to the home from the car park and there are accessible paths for ambulant residents to the rear of the building. The accommodation and facilities occupy three floors and a lift for eight persons accesses all three floors. The home is well maintained and furnished to a high decorative standard. The patio and garden areas are well maintained, sheltered and offer privacy. The home provides care and accommodation for up to twenty-five residents with low dependency needs and who are over 65 years of age. Information about the home is available in the form of a residents guide, which can be supplied to enquirers on request. A copy of most recent inspection report is available in the home. Fees range from 650 to 875 pounds per week. Additional charges are made
Care Homes for Older People Page 2 of 10 Brief description of the care home in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Care Homes for Older People Page 3 of 10 What we found:
Two Inspectors visited the home following concerns received anonymously. The caller alleged that staffing in the home was inadequate, and that on occasions people are cared for solely by male care staff which may be against their wishes. They said that the home is not managed well, medicine packs had been put in the wrong rooms and that one person was locked in her room for her safety because she got out into the car park unnoticed. On the morning of the inspection there were twenty one people using the service, seventeen female and four male. There were three care staff on duty, one male and two female. There was also a cook a, housekeeper and a maintenance man. The deputy manager arrived around 09.00 hours. The deputy manager told us that all but six people needed some form of personal care. He said they are all asked their preferences in respect of the gender of care staff but this is not recorded. The rota showed that generally there are three care staff in the morning, three in the afternoon and evening and two overnight. It showed that often there are two care staff between 14.00 and 16.00 hours and occasions when there have been two care staff in the morning. It showed that one morning there were solely two male care staff on duty. Staff told us that staffing in the home is a concern particularly if people are sick or on annual leave. They said they try to ensure that shifts are covered and very rarely employ agency staff. They said they try to ensure that the work gets done with little disruption to the residents. One member of staff said that some people go beyond their duties for the residents. They said they ask people using the service if they have any preference regarding the gender of care staff but nothing is written in the care plans. One male care assistant confirmed that he and another male were on duty together one morning as the female care assistant went sick. He said that one of the housekeepers helped out with the women who did not want a male care assistant. He said this person is undertaking an NVQ in care and works some shifts as a care assistant in the home. We were told that there have been staff cutbacks in the kitchen and housekeeping. The deputy manager said this is due to the recession. One housekeeper has been moved to the care team and one is doing some shifts with the care team. The home appeared clean and people using the service told us that cleanliness is very good in the home. They told us the food is always very good and is plentiful. They said the staff are busy but their care needs are met. People told us there is not much to do in the home but there are trips out each week that are enjoyable. Staff said they raised concerns to the Companys representative during her monthly visit to the home last week. A conversation with her following this inspection confirmed this was so and she said it is recorded in her report that will be given to the manager. She also said that she discussed staffing with the deputy manager during her visit and he told her he was having problems recruiting new staff. Staff told us they did not know who was in charge of the home in the absence of the
Care Homes for Older People Page 4 of 10 manager or her deputy. The deputy manager said that the senior care assistant would be in charge but confirmed that the person may not know this. He told us that eight care staff are seniors; the rota shows that sometimes two seniors work together. There needs to be clarification of who is actually in charge. We were told that the manager usually puts the medicine packs in the medicine cupboards in people s rooms. The deputy manager said that last week a care assistant, who was a qualified nurse, had done this. No one knew anything about packs being in the wrong rooms. The care file for the person allegedly locked in her room was examined. We found that the care plan lacked detail and did not instruct or direct staff. It did not indicate how staff should manage her behavior and there was no indication of her personal preference in respect of the gender of care staff. The daily records show that staff sometimes use diagnostic terms rather than recording what they actually mean. There were entries where this person was found on the floor and found in the foyer. There was one entry where she was taken outside by staff, in a wheelchair. There was no record of her being found outside or that she was locked in her room. This person is under the care of the Community Psychiatric Team and a Community Psychiatric Nurse (CPN) visits her. The CPN has written in the records giving monitoring instructions which have not been carried out. It was recorded that a GP visited and made a request, we found no evidence that this was followed through. Her medicine administration record was examined and had no photograph attached. Hand written instructions were not dated or signed by two staff. One entry had no information on how the instructions had been received from the doctor. There was no care plan for medicines that are to be administered as required. Staff said they did not know if this resident had managed to get outside but said she had been in the foyer. They said that to their knowledge she had never been locked in her room. We were told that she would probably not be able to open the door if it were closed so there would be no need to lock it. Staff were concerned about another resident who wanders around the home and we were told she went just outside the front door recently. One person using the service said she never sees the manager but the people who are downstairs see her. Staff said the manager walks around the home when she is there, they were unsure of whether she visited residents regularly. One person told us the home has gone downhill. The deputy manager said he works in the kitchen at weekends and has two days off during the week. He said the registered manager has Fridays and Saturdays off, she was on leave this week. The duty rota and staff confirmed what he said. He told us he is concerned about the staffing situation. What the care home does well:
Not all of the standards were assessed during this visit but we found that the home provides a good standard of care for the people living there. There is a nutritious menu on offer and people said they enjoy the food.
Care Homes for Older People Page 5 of 10 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 12 All of the people using the 01/12/2009 service must have a written care plan that details how their individual care needs are to be met. It must be available to them and must be kept under review. This will ensure that staff are informed and directed on how to meet the changing care needs of people using the service The Registered Provider must 01/09/2009 conduct a review of the management, staffing levels and skill mix of all staff . To ensure that the care home is able to promote and make proper provision for the health and welfare of people using the service. To include their care, and where appropriate, treatment, education and supervision. 2 12 27 Care Homes for Older People Page 8 of 10 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 9 Transcribing on MAR charts should be witnessed and signed by two staff. The name of the person authorising any change should be stated and how the information was received Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
