Trevella House

Trevella House is a residential care home providing personal care and accommodation up to 6 people. The service provides support to older people, younger adults and people with mental health needs. At the time of our inspection there were 6 people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection there were 2 people receiving personal care from the service.

People’s experience of using this service and what we found

Improvements were required in relation to the organisation and availability of records. In addition, further improvements were required in relation to audits undertaken to demonstrate action taken to address errors.

People received their medicines safely and as prescribed and were supported by sufficient numbers of staff to ensure that risk of harm was minimised.

The provider had safeguarding systems and processes in place to keep people safe. Staff knew about the risks to people and followed the assessments to ensure they met people's needs.

Staff had been recruited appropriately and had received relevant training, so they were able to support people with their individual care and support needs.

People felt safe and were supported by staff who knew how to protect them from avoidable harm.

Staff sought people's consent before providing care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way and in their best interests: the policies and systems in the service supported this practice. People's individual communication needs were considered to support them to be involved in their care.

Staff spoke positively about working for the provider. They felt well supported and that they could talk to the management team at any time, feeling confident any concerns would be acted on promptly. Staff felt valued and happy in their role.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for the service was good (published on 03 September 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. A decision was made for us to inspect and examine the information we had reviewed. As a result, we undertook a focused inspection to review the key questions of safe, and well led.

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 remained good. This is based on the findings at this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Trevella House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Trevella House is a residential care home providing personal care to six people with mental health needs at the time of the inspection. The service can support up to six people in one adapted building.

People’s experience of using this service and what we found

Quality assurance systems were in place but needed further development to ensure they consistently identified shortfalls. There was an open culture, led by the registered manager who was described by staff as being approachable and supportive.

People continued to tell us they felt safe and well supported. Staff had a good understanding in how they protected people from harm and recognised different types of abuse and how to report it. There were enough staff on duty to keep people safe and meet their needs. People received the medicines they were prescribed. Safe practice was carried out to reduce the risk of infection.

Staff received training that was appropriate to them in their role and supported them in providing care in the way people wanted. Staff spoke positively about the support they received. People were consulted about the menu and told us they enjoyed the food provided. Staff encouraged and/or supported people to attend health appointments, opticians and dental appointments, so they would remain well.

People were supported to have maximum choice and control of 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.

People told us that staff were kind and caring and treated them with dignity and respect. All the interactions we observed were respectful and professional. People were supported and encouraged to maintain their hobbies and interests.

The provider had a system in place for responding to complaints. People knew who to contact if they had any concerns.

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 requires improvement (published 22 August 2018) and there was one breach of the regulations in relation to provider's audits to assess; monitor and maintain an accurate, complete and up-to-date record of administered medication. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Trevella House 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.

Trevella House is registered to provide accommodation and support for a maximum of six people with mental health support needs. At the time of our inspection there were five people using the service. The provider is also the registered manager who was present during our inspection visit. 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.

The monitoring and recording of people’s medicines required further improvement. The shortfalls identified at this inspection had not been found by the provider’s audits. This meant the provider had not met all the legal requirements regarding their governance systems because their audits had not improved sufficiently in this area from the last inspection. Our regulatory response to this will be issued in a supplementary report once our decision is made.

People told us they felt safe and able to raise concerns with the provider. Staff members were aware of their responsibilities to protect people from the potential risk of harm and knew the processes they needed to follow to report any suspicions of abuse. Risks to people had been assessed and people felt involved in decisions about their support. There were some concerns raised about the numbers of staff on duty and their deployment to ensure people and staff members were fully supported and kept safe from any risk of potential harm. The provider’s recruitment processes had improved; employment checks had been undertaken on staff to ensure they were suitable for their roles. Staff members received supervision but there were mixed responses about the support they received from the management team to carry out their roles.

People told us they received adequate support with their medicines and did not raise any concerns, although the management and auditing of medicines required further improvement. There were processes in place to ensure the premises and household equipment was checked to maintain people’s safety. People were protected from the risk of infection. There were systems in place to investigate incidents and share learning when things went wrong.

People’s support needs were assessed. People were supported to make informed decisions about their support, offered choices and staff sought people's consent. People received support from staff that had received training. People told us they were happy with the support they received to maintain their nutritional health and wellbeing. We saw evidence that people were being supported to access healthcare professionals when required.

People told us that the staff members were kind, respectful and caring. We saw positive interactions between people and staff members. People were supported by staff that respected their privacy and dignity and promoted their independence. Staff members were aware of the provider's policies to prevent discrimination and promote equality and diversity at the service.

People told us they felt involved in their support, although there were mixed responses about receiving encouragement to follow interests and hobbies. People were confident any concerns or complaints would be appropriately responded to.

Trevella House is a residential home registered to provide accommodation and support for up to six adults with mental health needs. At the time of our inspection six people were living at the home.

There was a registered manager in post. 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.

At this inspection we found there had been some improvement to the service’s quality monitoring processes. However they still required further improvement to ensure people received a safe and effective service.

The provider had recruitment processes in place however they were not always robustly applied and required some improvement.

People received their medicines as prescribed by healthcare professionals. Medicines were stored and administered safely, although there was some improvement required on the recording of when medicines were administered.

People who lived at the home felt secure and safe in the knowledge that staff were available to support them, when they needed to be supported. The provider had systems in place to keep people safe from the risk of abuse.

People were protected from the risk of harm because staff followed up to date risk assessments to reduce the risk of harm for people who lived at the home.

Staff sought peoples’ consent before providing support. Staff understood the circumstances when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People were encouraged to be as independent as possible and were supported to make choices and to take responsibility for their own daily routines. People prepared their own food and drink at times to suit them and were encouraged to consider healthy food and drink options.

People were supported to access health care professionals to ensure their health care needs were met.

People were supported by staff that were kind, caring and respectful and knew them well. People were treated with dignity and respect and staff understood people's needs well. Staff received the training and support they needed to carry out their role.

People’s health and support needs were assessed and reviewed and they were encouraged to participate in activities and interests if they wished. People knew how to complain about the support they received and felt confident their concerns would be addressed.