Tigh Coilean

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

Guidance for staff of how to manage and mitigate known risks were not consistent or sufficiently detailed. Incident analysis procedures were not sufficiently robust to identify possible triggers and patterns to behaviors.

The procedure for completing best interest decisions were not sufficiently detailed. Staff had not fully received training in relation to people's health needs, but action was being taken to address this.

There was not a registered manager in place or a manager due to submit their registered manager application. Systems and processes to assess, monitor and mitigate risks needed some improvement.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were involved in their care and treatment as fully as possible and care and support maximised their choice, control, and independence. People received consistent person centred care from staff that knew them well and understood what was important to them. Staff were respectful and treated people with dignity. People were empowered to live active and fulfilling lives, opportunities to engage in stimulating and meaningful activities, interest and hobbies including social inclusion were provided.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were sufficient staff to meet people's needs and safe staff recruitment checks were completed before staff commenced their role. Staff received opportunities to discuss their work, training and development needs.

People received their prescribed medicines when required. Some people had experienced positive outcomes in the reduction of their medicines.

Overall infection prevention and control best practice guidance was followed. The environment and layout of the service met people's individual needs.

People received sufficient to eat and drink and healthy eating was encouraged. People were supported to access health services.

Staff were kind, caring and promoted people's independence. Effective communication methods were used to support people's different communication needs and preferences. People were supported with their interest and hobbies and encouraged to participate in a wide range of activities and social inclusion opportunities.

The provider had systems and processes to assess, review and monitor quality and safety. An action plan was in place to develop the service. Relatives were positive their family member received person centred care.

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 20 September 2017).

Why we inspected

The inspection was prompted in part due to concerns received about another service ran by the provider and the concerns raised by the Local Authority, which included poor governance and oversight and inappropriate use of restraint. A decision was made for us to inspect and examine those risks. As a result, we undertook a comprehensive inspection.

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 coronavirus and other infection outbreaks effectively.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement.

Please see the Safe, Effective and Well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Tigh Coilean on our website at www.cqc.org.uk

Tigh Coilean is registered to provide accommodation and personal care for six people who have a learning disability and/or a sensory disability. At the time of our inspection visit there were six people living in the home.

There was a registered manager in post. 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.

This was the services first comprehensive inspection. At this inspection we found the overall quality rating for the service was Good.

People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe from the risk of abuse. People had been supported to take reasonable risks while also being helped to avoid preventable accidents. Accidents and incidents were recorded and investigated. Medicines were safely managed and there were enough care staff on duty. Background checks had been completed before new care staff had been appointed.

There were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people.

Staff had received training and support and they knew how to care for people in the right way. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received supervision. This included knowing how to communicate with people who did not use verbal communication.

People enjoyed their meals and had choices about what they wanted to eat. People had access to drinks and snacks during the day. Where people had special dietary requirements we saw that these were provided for. People had access to healthcare and were supported to access these.

People were supported to make choices and be involved in decisions about their lives. Care staff supported them in the least restrictive way possible. The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

People were treated with compassion and respect. Care staff recognised people’s right to privacy and promoted their dignity. There were arrangements to help people access independent lay advocates if necessary and confidential information was kept private.

People were supported to pursue their hobbies and interests. They were supported to maintain relationships that were important to them. There were arrangements in place for dealing with complaints. People were supported to make complaints.

People had been consulted about the development of their home and quality checks had been completed. Good team work was promoted and care staff were supported to speak out if they had any concerns.

The provider had informed us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.

Further information is in the detailed findings below.