2 November 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
This inspection was carried out by one inspector.
Service and service type
Tower House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. The provider completed the Provider Information Return by the required date. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make.
During the inspection
We spoke with four people who used the service and one relative about their experience of the care provided. We spoke with four members of staff including the registered manager, deputy manager, and care workers.
We reviewed a range of records. This included five people’s care records and multiple medicine records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We sought feedback from one professional who regularly visits the service.
2 November 2019
About the service
Tower House is a residential care home providing personal and nursing care to 11 people aged 65 and over at the time of the inspection.
Tower House can accommodate up to 12 people in one adapted building.
People’s experience of using this service and what we found
Medicines were not always managed safely, and people did not always get their medicines as prescribed. Systems for ensuring peoples’ safety were not always managed effectively. There were sufficient staff to meet people’s needs. Infection control measures were in place.
Systems to monitor and improve the quality of the service were not always effective. The management team promoted a person-centred service that valued people as individuals. People described the service as ‘a family’ and were involved in decisions about the service.
Staff felt supported and completed training to give them the skills and knowledge to meet peoples’ needs. People were positive about the food and received food and drink to meet their dietary needs. The service had a good working relationship with health professionals and people were supported to access health services when needed.
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.
Staff were kind and caring. People and relatives described staff as ‘exceptional.’ People were treated with dignity and their choices respected. Staff encouraged and promoted people’s independence.
People’s care needs were assessed and there were care plans in place to guide staff in how to support people. People were able to spend their day as they chose and had access to some activities. Any issues raised were resolved and people were comfortable to raise concerns.
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 Good (published 13 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have identified breaches in relation to the management of medicines and the safety of people in the event of an emergency. The systems to monitor and improve the service are not effective.
Please see the action we have told the provider to take at the end of this report.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.