Tabley House

Updated 9 November 2021

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 Care Act 2014.

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 one inspector.

Service and service type

Tabley 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced. Inspection activity started on 07 October 2021 with the visit to the home and included a Microsoft Teams virtual meeting on the 22 October 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included comments from seven people who lived at the home and nine relatives which we gathered during our routine monitoring of the service in August 2021. We also sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three people who used the service and two visiting relatives about their experience of the care provided. We spoke with a visiting doctor and seven members of staff including the registered manager, the clinical lead nurse, two nurses, two care staff, and the regional operations director. We carried out a medications check, and looked at a range of other records, including assessments, care plans, risk assessments and audits.

After the inspection visit

Due to the impact of the COVID-19 pandemic we limited the time we spent on site. Therefore, we requested records and documentation to be sent to us, and reviewed these following the inspection visit and continued dialogue with the deputy manager by telephone. We reviewed a range of records. These included sample care records, assessments, and risk assessments. A variety of other records relating to the management of the service were also reviewed. We looked at the recruitment records for two recently recruited staff via a Microsoft Teams meeting.

Updated 9 November 2021

About the service

Tabley House is a residential care home providing personal and nursing care to 51 people at the time of the inspection. The service can support up to 59 people in one adapted building across two separate units, each of which had separate adapted facilities.

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

People and their relatives were unanimous in their praise for the management team, staff and the standard of care provided. Comments included, “This is a fabulous place I'm so lucky to be here." A visiting relative said, “they [staff] are excellent in everything they do.”, Another described the excellent care (their relative) had received, with dignity, excellent clinical care, and liaison with their doctor but all in a homely and welcoming atmosphere."

Risks to health, safety and welfare, of people who lived, worked and visited the home were identified and managed safely.

Safeguarding systems, policies and procedures ensured people were safe and protected from abuse.

Medicines were safely managed, and systems were in place for reporting accidents and incidents and learning from them.

We were assured by the additional measures in place to help prevent the spread of COVID-19. Risks relating to infection prevention and control (IPC), including in relation to the COVID-19 pandemic were assessed and managed. Staff followed good IPC practices.

Safe visiting was supported and enabled. Visitors were invited to take rapid COVID-19 test just before their visit, were provided with appropriate personal protective equipment as in accordance with government guidelines and best practice.

There were sufficient numbers of suitably trained and experienced staff on duty and safe recruitment procedures were followed.

Staff presented as well trained, caring professionals. They were engaging and showed skill and sensitivity in the way they responded to people.

The management team and staff were clear about their roles and responsibilities and they promoted a positive, person-centred culture.

Staff worked well together as a team, and there was good partnership working with others to meet people's needs. A visiting doctor who was the home’s clinical lead in the local Primary Care Network praised the management and staff teams for providing exemplary care and told us how they had worked in partnership to ensure people’s health care needs were met.

Effective systems were in place for checking on the quality and safety of the service and making improvements where needed.

Rating at last inspection and update

The last rating for this service was good overall (published 13 November 2018), with requires improvement in the well led area. There were no breaches of regulation, but improvement was needed to embed quality assurances systems.

Why we inspected

Our routine monitoring undertaken in August 2021 identified that the service had improved significantly on leadership and governance previously rated as requires improvement. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Please see the safe and well led sections of this full report.

Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service remains the same Good. However, the rating for Well led has improved to Good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.