We carried out a review of the data available to us about Temple Croft Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Temple Croft Care Home, you can give feedback on this service.
Temple Croft is a residential care home providing personal care for to up to 40 people. The service provides support to older people, some of whom may be living with dementia. At the time of our inspection, 25 people were using the service.
People’s experience of using this service and what we found
The provider used a 'dependency tool' to ensure enough staff were on duty to meet people's needs. Staff told us there were occasions when additional staff would have been beneficial to reduce staff stress levels due to COVID-19.
We have made a recommendation about the management of staffing levels.
People received support from staff who were recruited safely and received regular supervision to monitor their performance. Staff attended an induction programme and received ongoing training to support them to carry out their roles effectively.
People told us they felt safe and well cared for, staff knew their individual needs well. People told us the meals were lovely and spoke about activities they had participated in. People and their relatives said they could always go to a staff member or the registered manager if they were not satisfied, and they spoke positively of staff and the registered manager.
The premises were clean and tidy, people's rooms were personalised, and communal areas were homely. The layout provided people with the opportunity to socialise with others and spend time in quieter areas when needed.
People's dignity was promoted, and we observed positive interactions with staff. Managers and staff had positive working relationships with external agencies and healthcare professionals ensuring that people's needs were met in a timely manner.
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.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 17 September 2019) and there were breaches of regulation. 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 inspection was prompted by a review of the information we held about this service.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
We carried out an unannounced comprehensive inspection of this service on 12 and 20 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Caring and Well-led which contain those requirements.
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 requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for temple Croft Care Home 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.
Temple Croft is a residential care home providing personal and nursing care to people living with dementia and people aged 65 and over. At the time of the inspection 32 people were residing at the service. The service can support up to 40 people.
People’s experience of using this service and what we found
People's medicines were not always managed safely. Records were not accurate and we could not be assured people received their medication as prescribed. Staff received training but their competencies were not assessed. Risks to people were not always mitigated. Accident and incidents were not recorded correctly or monitored effectively so lessons could not be learnt. The risk of spread of infection was not always mitigated. Recruitment checks had been carried out but not fully explored.
There was no registered manager at the service. Governance systems were not robust and had failed to identified areas of concerns we identified. This included risk management, medication, infection control and activities. Where information could have been used to develop the service and improve standards of care this had not been done.
Feedback throughout the inspection was that people were happy with the care they received. People told us they felt safe. People’s diverse needs were met. There was limited activities observed during the inspection.
We have made a recommendation regarding activities.
We received positive feedback from people and their relatives regarding the staff. However, we saw one occasion were one person was not treated with respect by staff. People’s confidential information was not always protected.
People were supported to access health care however, we saw on one occasion this was delayed due to important information not been shared between staff. 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 with their nutritional needs.
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 8th March 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to the management of medicines and risks, and good governance.
Please see the action we have told the provider to take at the end of this 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.
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Temple Croft provides personal care and support for up to a maximum of 35 older people, some of whom may be living with dementia. The service is an old detached building which has been extended over the years. It is in a central location and local facilities and amenities are within walking distance. There is a good range of communal rooms on the ground floor. Bedrooms are provided on the ground and first floor with lift and stair access. At the time of our inspection visit there were 25 people using the service.
This inspection took place over two days on 24 January and 1 February 2017 and was unannounced. At the last inspection in November 2014, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.
The service was safe. Care staff had received training to ensure they knew how to recognise and report potential abuse. Risks to people were identified and plans were available to help manage and minimise these from occurring. At the previous inspection the registered manager had identified the provision of external storage facilities in a static caravan placed a potential risk to staff. At this inspection we found the caravan had been removed and replaced with a new shed, which removed this risk. Medicines were managed in a safe way and checks were made to ensure staff were competent to administer people’s medication. There were sufficient numbers of staff available to meet people’s needs.
The service was effective. Care staff were provided with effective training, support and development opportunities to enable them to meet people's needs. People were assisted to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice. A variety of food and drinks were provided to enable people to have choices about these and ensure their nutritional needs were supported and maintained. People's care records showed that, where appropriate, support and guidance was sought from relevant health care professionals, including district nurses and GPs.
The service was caring. People and their relatives were included in decisions about the way their support was provided. People were treated with dignity and respect and staff provided their support in a kind, caring and compassionate manner. People were consulted and their opinions and views were considered to enable the service to learn and develop.
The service was responsive. People received their support in an individualised way, which was personalised to meet their needs. A range of care plans were developed and reviewed for people that reflected their wishes and preferences. People were provided with a wide variety of activities to enable them to have opportunities for meaningful social interaction. People’s feedback, including complaints, was welcomed by the service and was acted upon.
The service was well-led. The service was inclusive and people, their relatives and staff were positive about the way it was managed. Systems were in place to enable the quality of service people received to be assessed and monitored, and these were being further developed to enable the service to continually improve.
Further information is in the detailed findings below.
We undertook this unannounced inspection on the 20 and 21 November 2014. The last inspection was completed on 7 July 2013 and the service was meeting the regulations we assessed.
Temple Croft provides personal care and support for up to 35 older people, some of whom may have needs associated with dementia. The service is an old detached building which has been extended over the years. It is in a central location and local facilities and amenities are within walking distance. At the time of our inspection visit there were 32 people living at the service. There is a good range of communal rooms on the ground floor. Bedrooms are provided on the ground and first floor with lift and stair access.
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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who used the service including relatives we spoke with made positive comments about the care and treatment provided. We saw staff treated people with dignity and respect and involved them as fully as possible in decisions.
People had their health needs met and had visits from professionals for advice and treatment. People received their medicines safely and on time and the registered manager was dealing with some recording shortfalls.
Storage facilities in the service were limited and additional storage in a caravan in the garden had been provided. The registered manager had identified some safety concerns for staff with this storage facility and taken action to limit access to the maintenance team. The registered manager confirmed they were in the process of addressing the issues with the registered provider.
The service had policies and procedures in place to protect people from abuse or harm. Staff told us they felt confident the registered manager would respond to and investigate any concerns they raised. The training records showed staff had received training in how to safeguard vulnerable adults from abuse.
A recent increase to the numbers of staff on duty in the mornings meant there were sufficient staff available to meet people’s needs and keep people safe. Staff had the right skills and experience and received an initial induction and on going training and support. Recruitment practices were safe and relevant checks had been completed before staff commenced work.
People’s nutritional and dietary needs were assessed and people were supported to eat and drink sufficient amounts to maintain their health. The staff made appropriate and timely referrals to health care professionals and recommendations were followed. Including support to attend routine health checks.
People told us that they felt included in discussions and decisions about their care and treatment. Information was available that advised people about independent advocacy services and information about the service including the registered providers’ complaints procedure. The service provided personalised care and treatment, people had been asked what was important to them in how they wished to be cared for. This information was reflected in their plans of care.
People who used the service, relatives and staff were positive about the leadership and said improvements had been made to the service. The registered manager regularly assessed and monitored the quality of care by completing audits and seeking feedback from people who used the service. Some negative comments had been received about the quality of furnishings. There had been some delays in developing the annual refurbishment programme, however the registered manager confirmed this would be completed by the end of the year, and all improvement works would be appropriately planned.
The registered manager told us, 'Care files and all assessments are reviewed when any changes in need occur or once a year as a minimum.' A relative said, 'I don't know what we would do without this place they are great with Dad and are really on the ball when his needs change.'
We saw that the home used 'blister pack' trays that medicine is 'popped out' of on the corresponding date. Blister packs are widely regarded as an effective tool to decrease administration errors, ensuring that the right drug is given to the right person at the right time.
A member of staff we spoke to said, "I've worked here for over 16 years, it's a great place to work we are all like family.' Another member of staff said, 'I am really supported in my role, the staff are great to work with and Ann (the manager) is always there if you need her, she will always make time for you.'
People had their comments and complaints listened to and acted on. We saw that a recent complaint had been responded to appropriately, investigated and the outcome was to be shared with the complainant.
People spoken with said they were well looked after and could access their GP and district nurse when required. Comments included, "Doctors and nurses come. You just ring them or the staff take you in their car" and "I see my GP every few months for check ups and blood tests."
People spoken with told us staff were caring and treated them well. Comments included, 'All the people who work here are very nice. Your bedroom is kept clean. You couldn't get any better' and 'I get on with most of the girls. They are very helpful, patient and treat you well'.
People told us they were able to express their views about how the service was provided at meetings and via questionnaires.