Archived: Templeman House

At our last inspection we rated the service good. At this inspection we found the service remained Good. Progress was being made towards outstanding achievement. 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.

The registered manager had worked at the service for many years. 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.

People were treated with kindness, respect and compassion, and their privacy and dignity was upheld.

People were protected from neglect and abuse. Risks were assessed and people were supported to stay safe with the least possible restriction on their freedom. Pre-employment checks were followed to ensure candidates were suitable to work in a care setting.

People’s physical, mental health and social needs were assessed holistically, and care and support was planned and delivered in a personalised way to meet those needs.

People, and where appropriate their families, were involved in decisions about their care and support. The registered manager and staff kept abreast of good practice through attending training and discussing developments in good practice at team meetings and during supervision. Staff had training in equality, diversity and human rights to help them challenge and avoid discrimination.

People's rights were protected because the staff acted in accordance with the Mental Capacity Act 2005. People and their relatives were encouraged to be involved in decisions about care.

Relatives and friends could visit when they wished without notice.

There were links with the local community.

People had access to meaningful activities and were encouraged to follow interests and hobbies.

People made choices about what they ate and drank. Mealtimes were relaxed and sociable occasions, with people receiving the support they needed to eat and drink at their own pace. Dietary needs were assessed and referrals made to dieticians or speech and language therapists as appropriate.

People were supported with their health care needs. They each had a ‘health passport’ to provide to hospital staff in the event they needed treatment there.

There were sufficient appropriately trained staff on duty to support people in a person-centred way. The service used regular agency staff, whom people knew, to fill any gaps in the rota.

Staff were supported through training, supervision and appraisal to perform their roles effectively.

Staff were valued, respected and supported to develop the service, through supervision, team meetings and ad hoc conversations with the management team. The service was open to the concerns of staff, whether through whistleblowing, supervision and staff meetings, or staff surveys.

Accidents, incidents or near misses were recorded and monitored for developing trends.

The premises were clean and well maintained. Individual bedrooms were furnished and decorated according to people’s preferences.

People were protected from the spread of infection.

Medicines were stored securely and managed safely.

The service sought to support people to have a comfortable and dignified death when nearing end of life.

Clear information about how to make a complaint was available for people. Complaints were taken seriously and investigated openly and thoroughly.

The service worked in partnership with health and social care professionals and other organisations, to ensure people’s care needs were met and that staff kept up with good practice.

The provider had quality assurance processes in place, which helped to maintain standards and drive improvement.

Templeman House is registered to provide personal care and accommodation for up to 41 people. These are mainly older people who are living with dementia. There were 29 people living in the home during our inspection.

Accommodation is arranged over three floors and there is a passenger lift to assist people to get to each floor.

At the time of this inspection the home had a registered manager. 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.

People and their relatives told us they were happy living at the home and felt safe there. Staff knew how to prevent, identify and report abuse and the provider had a system in place to protect people from the risk of harm.

People’s needs were assessed before they moved into the home and during their time there. Areas of risk were assessed such as, skin integrity, falls and mobility and nutrition. Regular reviews were completed to ensure people’s needs were continually assessed.

Staff appeared to know people well and gave good examples of how they preferred their care and support to be given.

People received their prescribed medicines when they needed them and appropriate arrangements were in place for the storage and disposal of medicines.

Equipment such as hoists, wheelchairs and pressure cushions were readily available, maintained correctly and used safely by staff in accordance with people’s care records.

Some areas of the provider's infection control processes required improvement, however the provider took immediate steps and provided an action plan which achieved this.

The provider was in the process of recruiting further staff. There was a system in place to ensure people were cared for, or supported by sufficient numbers of suitably qualified and experienced staff. The provider had good recruitment and selection procedures in place.

Staff spoke positively about the induction and training they received and told us they felt well supported to carry out their role.

The manager was aware of their responsibilities in regard to The Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty.

People were supported to make decisions and where people did not have the capacity, decisions were made in their best interest.

People’s care records were regularly reviewed and maintained and accurately reflected the care and support they required.

People knew how to make a complaint and felt confident they would be listened to if they needed to raise concerns or queries.

There were systems in place to monitor and improve the quality of the service provided.

We found people's needs were assessed and a plan of care drawn up to meet these needs. Daily records showed that support had been provided to meet people's needs. One person who we were pathway tracking told us their lunchtime soup "tasted good" and we saw they interacted with staff by smiling and responding to questions about their lunch.

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. One visitor told us they considered their relative was safe and "well cared for."

The provider had an effective system to regularly assess and monitor the quality of service that people receive. This included regular audits of the environment, care records and staff practice.

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.

Following the inspection on 5 November 2012 the home’s manager sent us an action plan. It set out how they intended to make sure that records were completed properly.

On this occasion we did not talk with anyone living at the home about their experiences of living at Templeman House. This was because our inspection was specifically about record keeping.

We saw a system had been put into place that ensured that documents were completed fully by staff members who were responsible for the task.

We examined a range of documents that described and recorded how people who lived at the home received the help and support they required.

On this occasion the sample of records that we looked at were all in good order.

We were unable to speak with most people living at the home because of their physical and mental frailty. We therefore also gathered evidence of people’s experiences by observing what was going on and staff working practices.

We saw that staff frequently checked the communal areas where people spent time during the day to ensure they were safe and their needs were being met. We saw that generally people's dignity was upheld.

People we spoke with told us they were “pleased” with the care and help they received. They said care staff were polite and kind. They told us their choices were respected. One person said, “The staff are nice, not grumpy or anything like that. You can please yourself when you get up and go to bed”.

People were positive about the food provided and said there was always enough to eat.

We saw that social activities were organised in which people could take part.

There were systems in place that ensured people’s medication was managed safely; equipment was maintained and serviced; new staff were recruited properly; and the quality of the service provided was monitored.

We found that records were not always completed properly and were not always accurate or up to date.