Tralee Rest Home

Updated 9 February 2023

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

The inspection was carried out by one inspector.

Service and service type

Tralee Rest Home 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. Tralee Rest Home 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought and received feedback from health and social care professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 4 relatives/friends or people who used the service. Some people were not able to express their views. 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 spoke with 10 members of staff including the providers, the registered manager, the head of care, senior care staff and care staff. We also received written feedback from some staff. We reviewed a range of records. This included all or parts of 6 people's care records and multiple medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including audits, training records and procedures were reviewed.

Updated 9 February 2023

About the service

Tralee Rest Home is a residential care home providing accommodation and personal care to up to 36 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 32 people using the service. The service was being provided in an adapted building based in a residential area of Whitstable.

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

People and their relatives were positive about the staff who provided support to them. People were happy in the company of staff. Staff spoke to people in a kind and caring way. However, there were concerns about the governance of the service and the support provided to people.

People were not always kept safe where there were risks from their health conditions. For example, risk assessments were not always in place and guidance from health care professionals had not always been followed. Care plans were not up to date and did not include the guidance staff needed to ensure they knew how to safely and effectively support people. There were significant risks from the environment which had not been identified and addressed prior to the inspection. For example, risks from fire and from hazards that could increase the risk from falls. Medicines had not always been stored at the correct temperature increasing the risk they were not effective. There were risks from cross contamination increasing the risk of the spread of infection.

The provider addressed the serious concerns identified at the inspection. However, governance systems in place at the service had not always identified these concerns prior to the inspection and were not effective at improving and maintaining safety and quality. Staff understood how to raise a safeguarding if concerns arose about abuse. However, the provider and register manager had failed to act to protect people from risk The registered manager had raised some issues with the provider; however, the provider had not always acted to address these.

There were gaps in care records which meant that the care provided to people could not always be effectively monitored to ensure people were getting the right support.

There were enough staff to support people and staff were recruited safely. The registered manager understood their responsibility under duty of candour. There were opportunities to feedback their views.

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 offered day to day choices and staff knew how to support people to make decision as appropriate.

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 16 December 2021)

Why we inspected

The inspection was prompted in part due to concerns about managing risks for people and fire safety. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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

Enforcement

We have identified breaches in relation to good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.