Archived: Tapton Court Nursing Home

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

In February 2014 we carried out a scheduled inspection at Tapton Court. We found people were not protected against the risks associated with the unsafe administration of medicines. This was because we saw an agency nurse leave the medicine trolleys unlocked and open. The trolleys were left unattended for several minutes. One person who used the service was sat nearby the trolleys. Other people who used the service were walking around the home and could have easily got hold of the medicines.

Following the inspection the provider sent us an action plan stating the action they would take so they could be assured people who used the service were provided with care that did not present a risk to people.

At this inspection we observed the home manager handle, dispense and administer medication to people appropriately and safely.

People told us they felt safe and staff understood their role in safeguarding the people they supported. Staff had received training in safeguarding to ensure people were protected from the risk of abuse. People who lived in the home said, 'I feel safe and happy here, everyone looks after me' and 'The staff make sure this place is safe.'

Care and treatment was planned and delivered in a way that was intended to promote people's welfare. Staff used risk assessments. There were risk assessments in place with people's planned care. These gave details of how individual risks to a person could be removed or minimised.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

Is the service effective?

Care files we checked confirmed that initial assessments had been carried out by the staff at the home before people moved into the home. This was to ensure the home was able to effectively meet the needs of the people. People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People and their relatives said they had been involved in writing them and they reflected their current needs. One visitor confirmed they were able to see their relative in private and that visiting times were flexible.

Is the service caring?

In February 2014 we carried out a scheduled inspection at Tapton Court. We found some people had not received a good standard of personal care and attention which meant that people's dignity and human rights had not been upheld.

Following the inspection the provider sent us an action plan stating the action they would take so they could be assured people who used the service had their privacy, dignity and independence respected.

At this inspection we found people were treated with respect and dignity by the staff. During our inspection we observed staff speaking with people who used the service in a friendly and caring way. We observed care and support was provided to people when requested. Care workers we spoke with demonstrated a good understanding of the people's needs and were able to give examples of how they promoted people's independence.

People we spoke with told us staff were, "very nice" and "great." A relative said, 'I visit my family member nearly every day and the staff are very patient and caring. I have never seen anything here that worries or concerns me.'

Is the service responsive?

Staff and a relative told us the care and support provided was flexible to the person's needs and adjustments could be made where required. Staff said they informed the manager if they felt any change in needs was required and the support was reviewed. For example one person was choosing to have their meals in their room and this was being provided.

People were able to join in with a range of activities. We observed staff treating people with kindness and helping them with their daily activities such as personal care and social activities. We saw staff spending time with people on a one to one basis and it was very evident that people enjoyed this.

People knew how to make a complaint if they were unhappy. One relative said, 'I have nothing to grumble about but if I did I could talk to any of the staff and they would listen and sort it out."

Is the service well-led?

In February 2014 we carried out a scheduled inspection at Tapton Court. We found the home was not maintained to appropriate standards of cleanliness and hygiene. We looked at the infection control audit completed by the provider's representative in November 2013. This had highlighted a number of issues that required action in order to improve standards of cleanliness and reduce the risk of health care associated infections. These actions were not signed off as completed. In January 2014 the acting manager carried out a further infection control audit and highlighted further issues that required action. These included hoist slings needing to be washed, soiled bags placed in small bags, carpets, chairs and equipment needing deep cleaning and bedrooms not being thoroughly cleaned. There was no evidence to show staff had been informed of these concerns or that any of the actions identified had been completed.

Following the inspection the provider sent us an action plan stating the action they would take to ensure there was an effective system to assess the risk of, and prevent and control the spread of a health care associated infection.

At this inspection we found the home had undergone a deep clean and stained carpet, equipment and chairs had been removed and replaced. We found cleaning schedules were completed by staff and then audited by the manager. Staff told us that any issues raised from the cleaning audits were addressed promptly by the home manager.

Following the concerns raised at the last inspection the service had worked well with other agencies and services to make sure people received their care in a joined up way. We saw evidence the service had taken advice provided by other healthcare professionals so that the quality of the service would be improved.

At the last inspection we found staff had not received supervision for over a year. We also found evidence that confirmed one staff member had been in disciplinary procedures in May 2013. Following this they had not been provided with any supervision. This meant that not all staff had received appropriate training and supervision to enable them to deliver care safely and to an appropriate standard.

At this inspection staff told us they had recorded supervision sessions with either the home manager or deputy manager and were kept updated about any information they needed to know about the service. This helped to maintain consistency in the running of the service and to ensure staff were aware of relevant information.

During our observations we found some people had not received a good standard of personal care and attention which meant that people's dignity and human rights had not been upheld.

People who were able told us that overall they were happy living at the home and satisfied with the care and support they were receiving. Their comments included, "Things are OK," "They [staff] come and help me if I need them" and "I'm quite satisfied, the staff are fine".

We found the home was not maintained to appropriate standards of cleanliness and hygiene.

We found people were not protected against the risks associated with the unsafe administration of medicines.

Suitable arrangements were not in place to ensure staff were appropriately supported to enable them to deliver care safely and to an appropriate standard.

The service had a system in place to deal with complaints, which included providing people with information about that system.

Records checked showed that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes. A relative we talked with told us, where people lacked capacity, they were involved in decision making. The relative also confirmed that they were satisfied with the care provided.

We found that, where necessary, people were supported with the administration of their medicines, by staff that were qualified and trained in medication administration.

The provider had an effective recruitment and selection process in place. We saw evidence that staff that were employed by the home had undertaken relevant checks before they were allowed to commence working.

We found that a complaints policy and procedure was in place. All of the people and their relatives spoken with said they had no complaints or concerns about the home.

Information that we received from Sheffield Local Authority, Contracting and Commissioning confirmed to us that they did not have any current concerns about the home.