Background to this inspection
Updated
3 November 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by 1 inspector.
Service and service type
HF Trust – Trelowen is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hf Trust - Trelowen is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service since the last inspection. We used all this information to plan our inspection.
During the inspection
We met with 4 people living at HF Trust Trelowen. We spoke with 3 care staff, the registered manager and the residential operations manager. We spoke with 2 relatives and communicated with 1 health professional.
We reviewed a range of records, including two people’s care records, medication records, staff recruitment files, the service’s training matrix, rotas and policies and procedures.
Updated
3 November 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
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.