Archived: Trippier

Updated 14 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 30 April and 1 May 2018 and was unannounced. The inspection team consisted of two inspectors and a ‘bank’ inspector on both days of the inspection. On the 30 April 2018, the inspectors were accompanied by 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. Our expert by experience had experience of caring for older people and people living with dementia.

We reviewed information that we hold about the service such as safeguarding information and notifications. Notifications are the events happening in the service that the provider is required to tell us about. We used this information to plan what areas we were going to focus on during our inspection.

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 11 people living at the service, one visitor, eight members of care staff, two team leaders, two housekeepers, the service’s chef and kitchen assistant; and the registered manager. The service’s general operation’s manager was present when the inspection team provided feedback of the inspection findings. We reviewed seven people’s care files, staff recruitment and support records. We also looked at a sample of the service’s quality assurance systems, the registered provider’s arrangements for managing medication, staff training records, staff duty rotas and complaint and compliment records.

Updated 14 June 2018

At a previous unannounced comprehensive inspection of this service carried out on the 19 and 21 2017, we found breaches with regulatory requirements relating to Regulation 9 [Person centred care], Regulation 10 [Dignity and respect], Regulation 12 [Safe care and treatment], Regulation 13 [Safeguarding service users from abuse and improper treatment], Regulation 14 [Meeting nutritional and hydration needs], Regulation 17 [Good governance] and Regulation 18 [Staffing]. As a result of our concerns the Care Quality Commission took action in response to our findings by rating the service as ‘Inadequate,’ placing the service into ‘Special Measures’ and amending the provider’s conditions of registration.

A further focused inspection was undertaken on the 12 September 2017 and at that inspection we solely looked at the domains of ‘Safe’ and ‘Well-Led’. The quality rating of the service remained ‘Inadequate’.

Trippier House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 36 older people and people living with dementia.

Trippier House is a large detached building situated in a quiet residential area in Colchester and close to all amenities. The premises is set out on two floors with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service on each floor.

The Local Authority had placed a restriction on the service provision following our last inspection to the service in June 2017. This inspection was completed on the 30 April and 1 May 2018 and was unannounced. At the time of this inspection there were 15 people living at the service.

Since our last comprehensive inspection to the service in June 2017 and focused inspection in September 2017, a new manager had been appointed and had been in post at Trippier House since the 6 December 2017. The manager was registered with us on 16 April 2018. 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.

The overall rating for this service is ‘Requires Improvement.’ However, the service remains in ‘Special Measures.’ We do this when services have been rated as ‘Inadequate’ in any key question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures.

Improvements were noted since our last inspection. Risks to people’s safety and wellbeing had been assessed and recorded. Moving and handling practices by staff were safe. The deployment of staff within the service was now suitable to meet people’s needs. Staff responded promptly when people used their call alarm to summon staff assistance. People were positive about the care provided and no evidence of poor care practices by staff were witnessed during the inspection. The dining experience for people was much improved and people’s comments about meals provided were positive. Care plans had been reviewed and updated; and these now reflected people’s care and support needs; and the care to be delivered. Training statistics for staff had improved and training was now embedded in staffs’ everyday practice.

However, further improvements were required to the service’s quality assurance arrangements at both provider and service level as these were not as effective as they should be. Visits by the registered provider’s representative had not identified the issues found as part of this inspection. The culture of the service was not open and transparent. There was evidence to show staff that raise concerns were not always supported and the issues raised taken seriously.

The Care Quality Commission had not been notified of all safeguarding concerns. Improvements were required to ensure investigations were robust as these had either not been undertaken or were incomplete and provided little evidence as to how outcomes had been reached. Reporting of accidents and incidents was inconsistent and not all complaints had been investigated and actions taken.

The registered provider’s arrangements to determine the service’s staffing levels remained contradictory and ineffective. Where staff had been promoted to a more senior role, staff had not received an induction to their new designated role. However, our observation at the time of the inspection showed the deployment of staff at Trippier House was appropriate and people told us there was enough staff around to care for them effectively.

Care plans now covered all aspects of a person’s individual care and support needs and risks to people were clearly identified and managed to prevent people from receiving unsafe care and support. People’s healthcare needs were met and people had access to a range of healthcare services. People received their prescribed medication and staff’s practice was safe. Staff understood and had a good knowledge of the Deprivation of Liberty Safeguards [DoLS] and the key requirements of the Mental Capacity Act [2005]. Suitable arrangements had been made to ensure that people’s rights and liberties were not restricted and people’s capacity to make day-to-day decisions had been considered and assessed.

Recruitment practices were safe. Staff received appropriate training and this was now embedded in their everyday practice. Newly employed staff received a robust induction and formal supervision arrangements were in place and staff confirmed they felt supported by the registered manager. People were able to participate in a range activities that met their social care needs and preferences. Staff had a good relationship with the people they supported. People were supported to maintain their independence where appropriate and had their privacy respected. The dining experience for people was positive and people had their nutritional and hydration needs met.

You can see what action we told the provider to take at the back of the full version of the report.