Talbot View

We found the following examples of good practice.

Safe practices were in place for welcoming visitors to the home. These included rapid COVID-19 testing, personal protective equipment (PPE), health and symptom checks and hand hygiene. Vaccination status was checked for all visiting professionals and records of staff vaccinations were maintained. Staff testing for COVID-19 was at the frequency in line with government guidance and a process was in place for monitoring.

People told us they felt safe and were happy living at Talbot View. We spoke with people informally as we walked through the home. We observed many kind and caring interactions between staff and people. Staff offered reassurance to people which offered comfort. The registered manager, deputy manager and staff at the home had worked hard to keep people safe. The providers policies and procedures were robust and frequent monitoring meant that the home worked safely and within good practice and government guidelines. The registered manager told us they were fully supported by the provider.

Supplies of PPE were in good supply, stock checks maintained, and we observed staff wearing this correctly. The registered manager told us hand washing and PPE compliance was monitored throughout the home. Staff had training in infection prevention and control and were shown how to put on and take off PPE correctly. The home was clean, tidy and free from clutter. Posters around the home had been laminated to ensure they were wipe clean. Emergency procedures in place meant that the home could operate under pressures such as an outbreak or staff shortages. Domestic staff worked hard to keep all areas of the home clean and tidy including frequent touch points and deep cleaning. Cleaning schedules were maintained and meant it was easy to keep track of hygiene practices within the home.

People were supported to maintain contact with their loved ones during the COVID-19 pandemic. Visiting restrictions changed and the home adapted its policies, practices and communicated to people and their relatives verbally, email or by telephone. Risk assessments were completed for all aspects of care and support including additional risks related to COVID-19. The registered manager and deputy manager told us they had an excellent working relationship with external health and medical practitioners, they felt supported and that this had improved greatly throughout the COVID-19 pandemic.

Talbot View 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.

Talbot View accommodates up to 59 people in four 14 or 15-bedded wings of purpose-built premises. There were 41 people living or staying there when we inspected. The two wings downstairs specialise in providing care to people living with dementia. The two wings upstairs are for people who require residential care due to frailty, illness and impairment in their old age. One of the upstairs wings was closed for refurbishment at the time of the inspection.

The service had a registered manager but they had left a few weeks previously and were due to apply to cancel their registration. The current manager had been in place since the registered manager left. They had applied to register with CQC and were awaiting a fit person interview. 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 and compassion. Staff knew and respected the people in their care. People’s privacy, dignity and independence was respected and promoted.

People were protected from abuse and neglect. Staff knew how to raise concerns about poor practice and suspected wrongdoing under the provider’s whistleblowing procedures.

People’s rights were protected because the staff acted in accordance with the Mental Capacity Act 2005, including the deprivation of liberty safeguards. Where people were able to give consent to aspects of their care, staff sought this before providing assistance. If there were concerns that people would not be able to consent to their care, staff assessed their mental capacity. Where they were found to lack mental capacity, a decision was made and recorded regarding the care to be provided in the person’s best interests.

Risks to people were assessed and managed in the least restrictive way possible. People were supported to take risks to maintain their independence as far as possible, for example, if they were able to walk they were encouraged to do so.

Some people living with dementia were on occasion reluctant to accept support with care, which could cause them to become distressed when staff attempted to assist them. The service had taken advice from specialist healthcare professionals. This had reduced the frequency of behaviour that challenged others.

People’s physical, mental health and social needs were assessed holistically, and individualised care was planned and delivered to meet these. Staff had a good understanding of people’s care needs.

People were supported to express their views and to be involved in decisions about their care.

People were supported to maintain a balanced diet and to have plenty to drink. People’s weights were monitored and appropriate action taken if people were identified as being at risk of malnutrition, such as pursuing referral to a dietitian. Similarly, if people were observed to have difficulty swallowing, a swallowing assessment was sought with a speech and language therapist.

Group and individual activities were based on people’s interests and needs. They were facilitated by an activity coordinator and designated care staff.

People had access to healthcare services and were supported to manage their health.

At the end of their lives, people were supported to die in comfort and with dignity.

There were sufficient safely recruited, competent staff on duty to provide people’s care and support. Staff had access to the training they needed.

Staff were positive about their roles and told us they were well supported by the provider and manager.

Medicines were stored securely and managed safely.

Equipment and facilities throughout the home had been checked and serviced regularly.

The premises were clean, free from clutter and odours, creating a pleasant living space for all the people living at Talbot View.

Lessons were learned and improvements made when things went wrong. Concerns and complaints were seen as an opportunity to bring about improvement. The manager and their team exercised their duty of candour, keeping people and where appropriate their relatives informed about what had happened as the result of an accident or incident.

The service operated openly and transparently, working cooperatively with other organisations to ensure people were safe and received the care and support they needed. There was open communication with people who used the service, their relatives and staff about developments and changes at the service. The manager spent time speaking with people. There were also meetings for people who used the service, their relatives and staff.

Quality assurance systems were in place to learn from current performance and drive continuous improvement.

Talbot View is registered to provide personal care and accommodation for up to 59 people. These are mainly older people who are living with dementia. There were 46 people living in the home during our inspection.

Accommodation is arranged over four living units. ‘Highmore’ is for older people and the other three living units are called ‘Warehams’, ‘Lollipop Lane’ and Butlers Brook’ and accommodate people who are living with dementia. Nursing care is not provided at Talbot View.

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.

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.

People received personal care and support in a personalised way. Staff spoke knowledgably about people and provided care in a kind and caring way. People’s privacy and dignity was maintained and people could receive visitors whenever they wished.

Records were accurate and up to date. Where people had particular nutrition and hydration needs, food and fluid intake was recorded, monitored and followed up so that any necessary action was taken.

There were robust medicine management systems in place. 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.

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 and staff were supported in their roles with ongoing training and supervision.

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.

There was a varied and full schedule of activities for people to take part in if they wished. The provider employed dedicated activity staff who provided a full programme of activities for people.

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 looked at documents and records and observed where it was appropriate the care and support people received.

We reviewed a report from the local authority contracts and commissioning department about the quality of care provided at Talbot View..

People received the help, assistance, prompting or supervision they required in accordance with their individualised care plans.

All the people we spoke with expressed positive views about the support they received and the food that was provided. They told us they thought there were usually enough staff on duty to meet their needs.

The provider had arrangements in place that ensured; consent was obtained from people for the care and treatment they received; people's nutrition and hydrations needs were met; people's prescribed medication was managed safely for them; the quality of the service was monitored and risks to people's welfare were identified and managed safely.

We spoke with two care staff about training they had received to enable them to work safely with equipment used in providing care for people.

People we spoke with who lived at the home all expressed positive views about their own bedroom accommodation as well as the accommodation they shared with other people. They told us that when staff supported them using equipment or aids such as hoists they felt safe. They said they thought the staff had been trained and were competent to use such equipment.

People told us they were confident that if they had any complaints they would be listened to and 'put right'.

We toured Talbot View and saw that it was divided into four group living units. Each unit had a separate lounge and dining room. We noted that there were 59 single bedrooms in the home and all had en-suite facilities.

The provider made arrangements that ensured that the building was safe and properly maintained.

There were also arrangements in place to monitor the quality of the service provided at Talbot View including checks that the provider's procedures were implemented properly.