Tunstall Hall Care Centre

The service is a residential care home providing personal care and support to older people some of whom were living with dementia.

The provider was previously in breach of the legal regulation in relation to governance. Improvements were not found at this assessment, and the provider remained in breach of this regulation.

Risk assessments were in place but risks to people were not always managed safely, particularly in relation to their nutrition and fluid intake. Safeguarding referrals and CQC notifications had not always been submitted when needed which meant relevant agencies were not always aware of risk in the home. People’s medicines were not always stored safely and we found some discrepancies with the recording of medicine administration.

People were not always referred to in a dignified way in care plans and in the way staff spoke about them. Staff told us they had observed some colleagues speak with people in a way that was not always kind and caring.

The culture in the home was not always person-centred. Whilst people were supported by a sufficient number of staff to meet their needs, practices at the home did not always ensure people’s needs were met at a time of their choice. Some practices such as the way in which meals and drinks were served were task-centred and did not always meet people’s individual needs. Staff told us the morale at the home was poor and they did not always feel they were treated equally. Staff were not always confident concerns would be addressed by management which made them reluctant to raise them.

Quality systems were not always effective in checking the quality of the home and identifying concerns so action could be taken to address them.

Whilst the provider was proactive in addressing concerns raised during the assessment process, they had failed to act on all the concerns raised at the last inspection such as in relation to medicines storage.

Despite the concerns we found, relatives provided positive feedback about the home and were confident people were safe living at the home. The home was clean, and staff wore Personal Protective Equipment (PPE) as required.

People were supported by a sufficient number of staff to meet their needs although some practices in the home meant their needs were not met at a time of their choice. Staff were safely recruited and supervisions were held with them to check their competence. Referrals were made to other health professionals when needed to meet their needs safely.

People were supported to maintain their independence and engage in activities inside and outside of the home.

Dementia training was undertaken during the assessment process to improve staff knowledge regarding how to meet people’s needs safely and more effectively. Professionals told us there had been an improvement in the provider’s engagement with them.