1 March 2016
During a routine inspection
Tranquility House is registered to provide accommodation and personal care for up to 20 people who may have dementia or similar conditions. The premises are a detached house situated on one of the main roads going in to Folkestone. The service has 16 bedrooms, four of which are twin rooms and all of which have a wash hand basin. Bedrooms are spread over three floors, which can be accessed by the use of a small passenger lift. The lift is not suitable for people using a wheelchair. People had access to four assisted bathrooms and a dining room, two lounge areas and a conservatory. There is a small car park and street parking available nearby. 18 people were living at the service at the time of the inspection, four people were sharing two of the twin rooms.
The service provider, Mrs Wratten, also works as the manager. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People’s safety was at risk because there was no safety test certificate for the electrical instillation at the service and no processes were in place to safely manage water to safeguard people against the risks of legionella. There were no systems in place to ensure checks had been completed on fire safety systems, gas, electricity and lifting equipment.
People were not always kept safe from abuse, staff were aware of safeguarding procedures, although policies and procedures were not current and not all staff had received appropriate training. Staffing levels were not sufficient to meet people’s needs all of the time and recruitment processes were not always thorough and robust. Accidents and incidents were not analysed to reduce the risk of reoccurrence.
Medicines were stored securely and safely. People received their medicines when they should but there were shortfalls in the recording of topical creams administration and in medicines that are prescribed to be taken ‘As required’.
Elements of care planning were not person centred to reflect differences in people’s individual needs. Some records at the service were contradictory about the support people needed and some support plans did not contain the level of detail needed in order to ensure staff supported people consistently. The arrangement of some activities reflected staff availability, rather than being planned to meet people’s needs.
People were supported to maintain good health as referrals to health professionals were made in a timely way. People’s privacy and dignity was not always fully respected. However staff were kind and caring in their approach to people.
Most risks associated with people’s care and support were assessed. People told us staff acted
with their consent and felt that they were treated respectfully and that their privacy and dignity were
promoted. People were able to choose their food at each meal time, snacks and drinks were always available. The food was home-cooked and people told us they enjoyed their meals, describing them as “Very good” and “First class”.
People or visitors did not have access to an up to date complaints procedure. There were no effective systems for monitoring the quality of care provided or assessing and mitigating risks within the service. Records were not accurate or available during the inspection. Policies and
procedures required review to ensure staff had clear guidance.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.