Teignbridge House Care Home Limited

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People felt safe and protected from the risk of harm and abuse. Staff knew people well and were able to notice any changes. Systems were in place to keep people safe. Records showed staff had been trained in safeguarding and told us how they would report any concerns, they were confident these would be dealt with appropriately. Care plans and risk assessments were clear and gave good instructions to staff about how to keep people safe whilst minimising restrictions. There were enough staff to meet peoples’ needs and staff had been recruited safely. Systems were in place to support staff and make sure they had opportunities to develop their skills and knowledge. Records showed a wide range of training had been completed. Individual accidents and incidents were reviewed and monitored to identify any developing trends that might indicate any changes in support. People’s medicines were looked after and administered safely, and they received them in the way prescribed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt they were safe. They said, “Staff look after me very well. I spend most of my time in my room and staff check on me and clean and change my [equipment]”, “Staff look after me very well. It suits my needs” and “Staff watch me take my medicines, it’s always regular”. Relatives said any issues were discussed with them. They commented, “I am pleased the staff notice and care about the small things, that nevertheless matter to my mother” and “My mother has a large white board so they can communicate. I can always discuss concerns from medical issues to finding a special blanket, staff know about people.”

Staff were knowledgeable about peoples’ needs and risks. They felt they had good training and told us about recent face to face training and how they had been supported to use the new electronic care planning system. One care worker said, “We have made significant improvements, and the system has really helped”. Another care worker said staff were ‘kept in the loop’ and that they all tried their best to meet the needs of all the residents, including their family. Risk assessments were clear and staff said they were updated regularly through the handover which was now documented on the system and available on their handsets. The cook said they were always told about peoples’ diets and we saw personalised meals being delivered with care.

There were clear care plans and risk assessments, including detailed plans about specific medical issues such as pressure care, care of specialised equipment, diabetes and catheter care. We saw risk assessments and care plans were reviewed regularly. Incidents and complaints were investigated and monitored. The office had been moved to make contact more accessible.

People said staff understood their needs and helped them if they needed healthcare. Relatives said, “I was pleased my mother was accepted at Teignbridge House. They have always contacted the GP promptly. When she was poorly staff stimulated and encouraged her to take an interest in things again and it wasn’t long before she was better”, “They picked up when my wife had an upset tummy, she got better and was normal again when I visited” and “Staff ensure my mother is moved regularly, she had a sore, but it has healed now. She eats a liquid diet, and they pay attention to possible choking hazards, they let us know what treats we can bring.” One person said, “They know what they are doing, they are very good. They [staff] picked up when I wasn’t well and got a doctor to see me.”

Staff felt care and support was well co-ordinated. They were able to tell us about one person who wanted to go home and how this was being supported in a safe way with the person and their family’s input. Staff knew peoples’ history and why they required support.

One health professional said, “We’ve never had huge concerns about this service. The staff are very helpful, very knowledgeable. There is good communication and people seem to like the staff. There is a good atmosphere.”

We saw people were supported with their families to access health care. Staff knew when peoples’ needs had changed and acted appropriately. People had clear Treatment Escalation Plans that had been discussed with them and their GP.

People felt supported by staff who were kind and helpful and people felt able to raise any concerns. Everyone said they felt safe. They said, “They know my needs and meet them” and It’s absolutely wonderful here. My neighbour came and said how wonderful it was too.” One relative said, “My mother is unable to walk but if something wasn’t right, she would say. Teignbridge House is a warm and caring place and Mum wouldn’t want to be anywhere else.”

Staff told us they knew how to report potential abuse and knew people well. They had received safeguarding training and were confident that managers would ensure the right action was taken.

We saw staff taking time with people when providing care and support. There was a lot of engagement through the site visits between people and staff. Staff recognised if people were not feeling well or were feeling low or anxious and spent more time with them.

Staff used the new electronic care planning system to report concerns, accidents and incidents. This enabled the management team to have oversight at any time. Safeguarding policy and processes ensured safeguards were made to the local authority as necessary. Records showed staff had all completed safeguarding training.

People felt supported by staff with their individual needs and were able to summon assistance should they need to. People said, “Staff look after me very well, they are always there to support me” and “Staff are good at changing and cleaning my [equipment] regularly.” One relative said, “My mother sits in a wheelchair during the day, staff check from time to time and adjust as necessary. Staff make sure her cushion is inflated.”

Staff felt they had enough clear information in the care plans which they could access using handsets at any time. Monitoring records were kept up to date. For example, people who spent time in their rooms were checked on, pressure care management was good, there were no pressure sores, catheter care was well managed with clear input and output records. Specialist mattress checks were completed with care plans detailing people’s current weight and mattress settings.

Staff were observed using equipment safely, which was readily available and safely stored. They took time and enabled people to be as independent as possible and do what they could when mobilising. They communicated well.

Risks to people had been fully assessed and risks identified. Any increased risk such as issues with medicines or mobility were reviewed and appropriate health professionals contacted. Emergency evacuation plans were in place and easily accessible, which described the support each person would need in the event of an emergency. These were up to date and reflected people’s current needs.

People felt they were supported in a safe environment and told us they felt safe. They said they were able to have their room as they wanted so enabling them to have safe and personalised spaces.

The provider was organising equipment repair during our site visit. They showed us the maintenance records and plan. Staff said if they had any issues they were resolved in a timely way.

The premises were clean and tidy whilst remaining homely. Communal and private spaces were kept free from clutter to minimise falls and enable an effective space for using mobility equipment safely. Staff received training on how to use equipment safely.

The equipment log was completed to ensure equipment was safe to use showing regular checks. Records were up to date for external professional visits such as fire extinguishers and hoist slings. There were window restrictors present throughout the building.

People and relatives spoke highly of the staff team. People said, “I have a shower supported by staff, they are all very good. I’m not fussed who does it”, “It’s very welcoming and very nice, everyone has been very kind” and “The staff look after me very well, they are good at coming in to me when I ring my bell, I don’t have to wait long.” Relatives said, “I have always been made to feel welcome and I’m always greeted in a friendly manner by staff” and “I am welcomed by staff and they often mention how my mum has been since my last visit. They are very good.”

Staff said they worked well as a team. One care worker said, “We can have agency staff who are usually regulars and know people well if we need to.” Staff said they felt there was enough staff and that the staff team was stable. Staff felt well supported and records showed up to date supervision and appraisals where staff could discuss any training needs or concerns with management. Staff all commented that they had worked hard to improve the service. They said, “It was low for a bit, but we are a good team, this is a nice home” and “Care records have improved so it’s easier now. We don’t rush and everything gets done. We all care about the residents, that’s why we are here.”

We saw staff working hard but in an unrushed way. They were attentive to people and had time to chat. People and staff seemed to get on well and knew about each others lives. Call bells were not always ringing and the atmosphere was homely and calm. The provider lived on site and was present. They clearly knew people well and people knew them.

People were supported by staff who had been safely recruited. Training records showed completed training suitable for their roles. The provider used a dependency tool to ensure there were enough staff to meet peoples’ needs. For example, currently 6 people required two care workers for support and 8 people required a hoist to mobilise. The service was not accepting new admissions where people had high needs to ensure staff could meet peoples’ needs at present.

People told us the home was clean. They said, “My room is cleaned regularly”, “It’s very, very clean, they are hoovering every day” and “The equipment they use on me is always clean.”

Staff said there was always a domestic available and they also contributed to keeping the home clean. Plants were watered and there was a homely feel.

We saw all areas of the home including the garden were well maintained. We saw staff using clean equipment and they were using the correct personal protective equipment and disposed of this correctly.

The cleaning schedule was all completed. Staff had received training in infection control. There were audits in place to monitor the cleanliness of the service.

People’s medicines were given safely as prescribed. Medicines were administered in a timely manner and recorded on people’s medicines administration record (MAR) charts. We saw that people’s preferences were considered, and medicines were observed to be given in a kind and caring way. People had personalised information recorded to help identify and support their needs for when required ‘PRN’ medicines would need to be administered. People’s medicines were kept under review by the GP surgery. People said, “My medicines are on time and I’m watched while I take them” and “I take my medicines while staff watch.”

Staff told us they felt supported with medicines by the managers, and by the GP surgery and pharmacy. Staff received medicines training and had recently recorded competency assessments. Staff we spoke with were knowledgeable about people’s needs and their medicines.

Medicines policies were in place to support staff. Medicines were stored securely and at appropriate temperatures and there were suitable arrangements for ordering and disposal. Records were kept of training and competency checks for staff. Medicines audits took place which helped to identify any areas for improvement.