Tallis House

Updated 15 September 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

This inspection was carried out by three inspectors and an 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.

Service and service type

Tallis House 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. Tallis House 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 not a registered manager in post. A manager had been appointed who was in the process of completing their application to register with CQC.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 all this information to plan our inspection.

During the inspection

We spoke with ten people who used the service and three relatives about the service. We spoke with 17 members of staff, including the manager and two deputy managers.

We reviewed 12 people's care records and multiple medicine records and monitoring charts. We looked at three staff files in relation to recruitment and a variety of records relating to the management of the service. 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.

Updated 15 September 2022

About the service

Tallis House is a care home providing accommodation for people who require nursing or personal care. The service can support up to 101 people. The service provides support to older people some of who are living with dementia. At the time of our inspection there were 68 people using the service.

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

There were not enough staff deployed to meet people's needs. Whilst dependency tools identified there were enough staff to meet people’s needs, feedback from staff, people and relatives did not support this. There were suitable recruitment processes in place. However, these had not always been consistently followed.

People's medicine support was being managed safely. The service was hygienic and infection control measures were being manged to help prevent the spread of infection. However, some improvement was needed to ensure the service followed all best practice guidance.

Staff did not always have the necessary knowledge, skills or competencies to meet people's needs safely. We received mixed feedback about the culture of the service, with some staff saying they did not always feel well-supported or listened to by the management team.

Systems to monitor and assess the quality of the service were not robust. The provider had not identified all of the issues we found on this inspection .

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 positive about the staff that supported them.

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 17 June 2021)

Why we inspected

We received concerns in relation to the management of accidents and incidents, weight loss and people’s hydration needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to staffing, staff training and support and governance arrangement at this inspection.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.