Background to this inspection
Updated
16 October 2021
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.
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 and a pharmacist inspector carried out this inspection
Service and service type
Trewiston Lodge Nursing home 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. 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
We gave a short period notice of the inspection to ensure the service was no longer in isolation following a recent COVID-19 outbreak.
What we did before the inspection
We 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 used all of this information to plan our inspection.
During the inspection
We spoke with eight people who used the service and one relative about their experience of the care provided. We spoke with the clinical lead, two registered nurses and four members of staff as well as the nominated individual and registered manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
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 a range of records. This included seven people’s care records and seven medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. We looked at training data.
Updated
16 October 2021
About the service
Trewiston Lodge Nursing Home is a care home which offers care and support for up to 32 predominantly older people. At the time of the inspection there were 28 people living at the service. Some of these people were living with dementia. The service occupies a detached house over two floors.
People’s experience of using this service and what we found
People and their relatives told us they were happy with the care they received, and people said they felt safe living there. A relative said; “They know her well and are respectful.” One person said; “Staff are nice.” People looked happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service.
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 supported by staff who completed an induction and were supervised. Staff were recruited safely in sufficient numbers to ensure people’s needs were met. There was time for people to have social interaction and activities with staff. Staff knew how to keep people safe from harm.
Staff received appropriate training and support to enable them to carry out their role safely, including fire safety and dementia training.
The environment was safe, with upgrades ongoing and people had access to equipment where needed.
Nurses supported people to take their medicines safely and as prescribed. We recommended that additional information about how people liked to take their medicines should be recorded in people’s care plans.
People were supported to access healthcare services. Staff recognised changes in people's health, and sought professional advice appropriately.
Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People’s communication needs were identified, and where they wanted, people also had end of life wishes explored and recorded.
People were involved in menu planning and staff encouraged them to eat a well-balanced diet and make healthy eating choices. Special diets were catered for.
People were supported by a service that was well managed. Records were accessible and up to date. The management and staff knew people well and worked together to help ensure people received a good service.
People and their families were provided with information about how to make a complaint and details of the complaint’s procedure were displayed at 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 full inspection took place on 5 June 2018 when the service was meeting the legal requirements (published 28 June 2018). The service was rated as Good at that time. Following this inspection, the service continues to be rated as Good.
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
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 Trewiston Lodge Nursing home on our website at www.cqc.org.uk.
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.