28 January 2020
During a routine inspection
Timkin Grange is a residential care home providing personal and nursing care to 66 people aged 65 and over at the time of the inspection. The service can support up to 66 people.
Timkin Grange is a purpose-built care home which accommodates people across three floors. Each floor has a communal lounge, dining area and kitchen. All bedrooms have private en-suite facilities. There are two lifts operating between floors which also give access to a library, cinema café and bar. There are communal gardens and parking.
People’s experience of using this service and what we found
Temporary staffing checks required further development to ensure staff were suitably trained, and they required further support and guidance to ensure people’s holistic needs were met. We have made a recommendation around this.
People had not been consistently protected from abuse. Medicines were not consistently managed safely.
People were not always supported as per their care plan with food and drink. People’s weight and food and fluid intake was monitored and recorded. People were supported with a fortified diet where required.
Laundry procedures had not been adhered to and people had lost clothing and items which were special to them.
Complaints and incidents had not been well managed, however, lessons were learned and shared where things had gone wrong and the provider continued to work on improving the service and develop more positive relationships with people.
Safety checks were not always recorded. However, the building was safe and well maintained we observed safety checks taking place during the inspection.
Internal auditing processes had not maintained oversight of the quality and safety of the service and we found gaps in several areas of record keeping.
Individualised activities were limited. People in their rooms or who needed help with mixing and meeting people were at risk of social isolation
Communication between the service and professionals was not consistently effective, for one person this had a negative impact on their well-being. Visiting professionals such as chiropody, district nurses and GP’s visited the service regularly.
People were not always satisfied with the continuity of care but told us staff were kind and caring.
Staff had not been trained in end of life care, but some staff were experienced in this area. End of life decisions were in place where needed,
The provider understood the regulatory requirements.
DBS checks and staff references were completed and there were enough staff available to keep people safe.
The staff and management team sought advice from other professionals to plan and deliver people’s care where needed. Care plans were person centred and detailed people’s cultural and religious needs. People and their families were involved in the assessment and review process.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were offered choice and were included in making decisions in the home.
People were protected from the spread of infection. Staff used protective personal equipment when supporting people with personal care. Staff received regular training and felt the culture of the service had improved.
There was a range of planned activity delivered by an enthusiastic friendly team, and the home was an active part of the local community.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection The last rating for this service was requires improvement (published 9 March 2019).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach in relation to the providers oversight of the safety and quality of the service.
Please see the action we have told the provider to take at the end of this full report.
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.