Archived: Timken Grange

Updated 3 April 2020

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector, one assistant inspector and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Timkin Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission however they were not working in the service at the time of the inspection and were due to deregister with CQC. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We contacted Healthwatch Northamptonshire, Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also contacted the local authority for feedback. We used all this information to plan our inspection.

During the inspection

We spoke with eight people who used the service and three relatives about their experience of the care provided. We spoke with twelve members of staff including, the interim manager, the activities coordinator, the maintenance person, a host, a cleaner, three care assistants, two temporary care assistants, two deputy managers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included five people’s care and support records. We looked at records in relation to training and staff supervision. A variety of records relating to the environment, maintenance and the management of the service and medication were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training schedules, Deprivation of Liberty Safeguards (DoLs) oversight and action plans.

Updated 3 April 2020

About the service

Timkin Grange is a residential care home providing personal and nursing care to 66 people aged 65 and over at the time of the inspection. The service can support up to 66 people.

Timkin Grange is a purpose-built care home which accommodates people across three floors. Each floor has a communal lounge, dining area and kitchen. All bedrooms have private en-suite facilities. There are two lifts operating between floors which also give access to a library, cinema café and bar. There are communal gardens and parking.

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

Temporary staffing checks required further development to ensure staff were suitably trained, and they required further support and guidance to ensure people’s holistic needs were met. We have made a recommendation around this.

People had not been consistently protected from abuse. Medicines were not consistently managed safely.

People were not always supported as per their care plan with food and drink. People’s weight and food and fluid intake was monitored and recorded. People were supported with a fortified diet where required.

Laundry procedures had not been adhered to and people had lost clothing and items which were special to them.

Complaints and incidents had not been well managed, however, lessons were learned and shared where things had gone wrong and the provider continued to work on improving the service and develop more positive relationships with people.

Safety checks were not always recorded. However, the building was safe and well maintained we observed safety checks taking place during the inspection.

Internal auditing processes had not maintained oversight of the quality and safety of the service and we found gaps in several areas of record keeping.

Individualised activities were limited. People in their rooms or who needed help with mixing and meeting people were at risk of social isolation

Communication between the service and professionals was not consistently effective, for one person this had a negative impact on their well-being. Visiting professionals such as chiropody, district nurses and GP’s visited the service regularly.

People were not always satisfied with the continuity of care but told us staff were kind and caring.

Staff had not been trained in end of life care, but some staff were experienced in this area. End of life decisions were in place where needed,

The provider understood the regulatory requirements.

DBS checks and staff references were completed and there were enough staff available to keep people safe.

The staff and management team sought advice from other professionals to plan and deliver people’s care where needed. Care plans were person centred and detailed people’s cultural and religious needs. People and their families were involved in the assessment and review process.

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 were offered choice and were included in making decisions in the home.

People were protected from the spread of infection. Staff used protective personal equipment when supporting people with personal care. Staff received regular training and felt the culture of the service had improved.

There was a range of planned activity delivered by an enthusiastic friendly team, and the home was an active part of the local community.

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 9 March 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the providers oversight of the safety and quality of the service.

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

Follow up

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.