Tulip Gardens

Updated 18 November 2022

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

Two inspectors visited the service on the 30th August 2022. One assistant inspector carried out phone calls to relatives on the 31 August 2022.

Service and service type

Tulip Gardens 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. Tulip Gardens 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 30 August 2022 and ended on 22 September 2022. We visited the location’s service on 30 August 2022.

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 used information gathered as part of monitoring activity that took place on 19 May 2022 to help plan the inspection and inform our judgements. We sought feedback from the local authority. 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 spoke with five relatives and two people who used the service. We spoke with five staff including the registered manager and four support workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed three people’s medication records and two people’s care plans and risk assessments. We viewed two staff recruitment files and the processes around staff recruitment. We reviewed staff training information and documents relating to how the service was monitored.

Updated 18 November 2022

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

Tulip Gardens is a residential care home providing personal care to eight people at the time of the inspection. The service can support up to eight people some of whom are living with physical disabilities, learning disabilities, sensory impairment and autism.

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

Based on our review of Safe and Well led the service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support:

People had not always had the risks associated with their care assessed, monitored and mitigated.

The provider had not always ensured incidents were reviewed to reduce the chance of reoccurrence and take learning from them.

The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. Staff communicated with people in ways that met their needs. 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.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care:

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

Right Culture:

Systems and processes to monitor the quality and safety of the service had not always been effective.

Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff felt well supported in their role, felt able to raise any concerns and enjoyed their roles in supporting people who lived at the service.

People and those important to them were involved in planning their care. The service enabled people and those important to them to worked with staff to develop the service.

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 25 August 2018).

Why we inspected

We undertook this focussed inspection as part of a random selection of services rated Good and Outstanding.

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 Safe and Well Led sections of this report.

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.

Enforcement

We have identified breaches in relation to how incidents and accidents were managed and in how the systems at the service enabled oversight and monitoring.

Please see the action we have told the provider to take at the end of this report.

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.