The inspection took place on the 14 November 2018 and was unannounced. Terrys Cross House is run by a registered charity and has a committee of trustees who oversee the service. Accommodation and personal care is provided for members of the clergy, missionaries, their dependents and those associated with them. The service has an integral chapel where regular services are held. People with no association to the church would also be considered if their care and support needs could be met.

Terrys Cross House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Care is provided to up to 12 people on a permanent basis or for respite care. At the time of the inspection nine people were living in the service, but one was not present during the inspection. The service is situated in Woodmancote with easy access to local amenities and transport links.

The service had a new registered manager who had commenced working in the service in August 2018. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. One person told us of the new registered manager, “We needed someone at the helm. They were wonderful when there was not a manager. But we have found a champion a real winner. It’s made the house feel more complete.” A member of staff said, “(Person’s name) is passionate about the place and she gets things done. She is involved with the people and out and about. You could not ask for a nicer boss. It’s made such a difference. She will muck in anytime. We are like a small family.”

At our last inspection on 26 September 2017 we rated the service Requires Improvement. We found breaches in the regulations in relation to recruitment procedures and there had been a failure to establish and operate effective systems to assess, monitor and improve quality and safety. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the areas highlighted. This was the focus of this inspection. We found improvements had been made and the breaches have been met. However, we have identified further areas in need of improvement. At this inspection we found the evidence continued to support the rating of Requires Improvement.

There was a period since the last inspection when there was not a registered manager on site. The trustee and registered manager acknowledged due to staff changes there had been a period when some of the systems to be followed had fallen behind or had not been fully maintained. For example, staff training, supervision and appraisal had been delayed. Some quality assurance checks had fallen behind, for example no infection control audits had been completed. Care plans and risk assessments needed updating. Some building checks for example in relation to legionella, risk assessments and fire drills had not been completed. There were records of checks of the hot water delivered. However, these records detailed the temperature was not at the recommended safe temperature of 43 degrees Celsius. There were no supporting risk assessments completed. However, senior staff had sought the advice and support of an external company to work with them. They spoke to us about the work already completed and booked to address the issues highlighted. They were aware of the shortfalls identified in the report there was a robust action plan was in place which they had been following to address this. These were areas in need of improvement.

People were protected from the risks of abuse as staff understood the signs of abuse and how to report c

We carried out this inspection of Terrys Cross House on 26 September 2017. The visit was unannounced and started at 07.30am to allow us to meet with the night staff before they went off duty and see how duties were allocated for the day.

Terrys Cross House is a care service originally registered with the Care Quality Commission (CQC) in 2015 to provide accommodation and personal care to clergy from the Anglican community, their siblings or spouses. The service will also now accept people without this link. The service is overseen by Terrys Cross House Trust which is a registered charity, and has a committee of Trustees who oversee the service. Terrys Cross House is registered for up to 12 people needing personal care. The service does not provide nursing care; this is provided by the community nursing team if needed.

Eight people were living at the service at the time of the inspection with one person staying on a short term basis. On the inspection we identified that only two of the people living at the service were receiving personal care. Most people living at the service were independent and active, and had chosen to enjoy living in a community of likeminded people with a similar spiritual background. For some of these people, although they were not yet receiving personal care, the service monitored their wellbeing discreetly and would escalate any concerns about their health or welfare to supporting agencies.

As people not receiving personal care would fall outside of CQC regulation, we have only included information relating to people receiving personal care in this report. However some information relating to the maintenance of the building, although only affecting people not receiving care at this time, had the potential to affect those receiving care in future, as they related to part of the registered premises. As a part of the inspection we also received comments from people not receiving personal care, who were keen to share their positive experiences of the service.

This was the first inspection of the service since their registration in 2015.

The service has a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

The service had quality monitoring systems in place to ensure care and support provided continued to meet the needs of people, and that they received consistent quality care. However we identified a number of instances on the inspection where improvements were needed. Not all of these had been identified by the service’s quality assurance or management systems, which told us they were not always working effectively.

People were supported by sufficient numbers of staff to meet their needs, however, improvements were needed to the staff recruitment processes to ensure decision making regarding any risks identified during the recruitment process was recorded. Photographs of staff were not all in place in their files, and the service had not ensured a full employment history was available for each staff member employed. However we did not identify any harm had occurred as a result of this. The registered manager took immediate action to resolve this while we were at the service, and confirmed they would be asking staff to complete these retrospectively.

Terry’s Cross House is a period property set in extensive grounds. The building has large and gracious rooms; however this came with challenges for the Trust in keeping on top of repairs and renovations. We were told new boilers had been installed in the last year to heat the whole building. We were informed there were currently some issues with the roof. The registered manager and a trustee confirmed this work was due to be done but had been held up because of a bat colony