About the service:The Trio House is a care home that provides personal care for up to three people with learning disabilities within one adapted building over two floors. At the time of our inspection, three people were living at the home.
People's experience of using this service:
• The provider had not taken appropriate steps to reduce the risk from fire at the premises and ensure people could safely escape in the event of a fire.
• The risks associated with people’s individual care and support needs had not always been fully assessed and managed.
• The equipment in use to meet people’s needs was not always safe for such use.
• The provider had not always reported safeguarding concerns to the relevant external agencies in order that these could be investigated externally.
• We were not assured the current shift pattern, and length of some staff members’ shifts, promoted people’s safety and wellbeing.
• Whilst pre-employment checks were in place, the provider did not explore gaps in prospective staff’s employment histories.
• People received their medicines as intended from trained staff, but written guidance was not always available on the use of ‘when required’ (PRN) medicines.
• Staff spoke positively about the provider’s induction programme. However, this had not been reviewed to incorporate the requirements of the Care Certificate.
• Information about the management of people’s health conditions was not always sufficiently clear.
• The provider had not always proactively sought advice from relevant community health and social care professionals in response to people’s changing needs.
• The use of ‘colours’ to refer to each of the people who lived at the home did not reflect a respectful approach.
• The provider’s quality assurance systems and processes were not sufficiently effective.
• The provider had not always told us about safeguarding issues involving the people who used the service.
• The provider and staff took appropriate steps to protect people from the risk of infections.
• Staff received training and ongoing management support to help them work safely and effectively.
• People had support to maintain a balanced diet and to make choices about what they ate and drank.
• The home provided a comfortable, ‘homely’ and well-furnished environment for the people who lived there.
• The provider and staff team understood and promoted people’s rights under the Mental Capacity Act 2005.
• Management and staff provided people's day-to-day care and support in a patient, attentive and caring manner.
• Staff promoted effective communication with people.
• People’s care plans were individual to them and read and followed by staff.
• People had support to participate in social and recreational activities.
• People’s relatives were clear how to raise any concerns or complaints with the provider.
• Steps had been taken to identify people’s wishes regarding their future care.
• Staff had positive working relationships with the management team and felt well-supported and valued in their work.
• People’s relatives felt involved in the service and spoke positively about the overall standard of care and support provided to their loved ones.
Rating at the last inspection:
At the last inspection the service was given an overall rating of ‘Requires Improvement’ (inspection report published on 21 August 2018)
At this inspection, we found the service met the requirements for 'Requires Improvement' in three areas and 'Inadequate' in the two remaining areas. The overall rating of the service was ‘Inadequate’ and the service is therefore in ‘special measures’. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Why we inspected: The provider registered with the Care Quality Commission (CQC) in December 2010. The inspection was prompted in part by information of concern shared with CQC regarding the alleged abuse of people who lived at the home. These allegations are subject to an external investigation by the local safeguarding adults team.
Enforcement / Improvement action we have told the provide to take: Full information about CQC's regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any information of concern is received, we may inspect sooner.