The Towans Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.
At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.
 

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a proactive and positive culture of safety based on openness and honesty. Lessons were learnt to continually identify and embed good practice. There was a process in place to record accidents and incidents, with audits of themes and trends completed.
Staff told us they had a learning culture. One staff member told us, “We hand over important information and discuss it with the team. As a senior team we look at ways to improve.” The registered manager gave examples of how they shared learning from incidents with staff.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.
Records of individuals' care needs were maintained for sharing with other professionals when necessary. A process was in place to ensure relevant information was communicated when individuals were admitted to hospital.
 

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.
People told us they were safe. One person told us, “I feel safe and the staff treat me well with kindness and give me dignity.”
Staff understood their responsibility to report abuse and neglect both internally and externally, they told us they felt confident to do this. One staff member said, “I would report it to management and I am confident they would take action, I would go higher if needed or to CQC.”
People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that where people needed to be deprived of their liberty to keep them safe, the provider ensured a DoLS authorisation had been made., This meant people’s rights were fully respected.
 

The service worked well with people to understand and manage risks. They provided care to meet people’s needs that was safe and supportive.
Risks to people were identified in care plans and there were control measures in place to mitigate the risks. Areas covered included, moving and handling, health needs, skin damage, malnutrition and people’s Personal Emergency Evacuation Plans (PEEPS). There were risk assessments in place for falls prevention, including the risks relating to the stairs. The provider was using an AI system to help prevent and detect falls in home. They were also arranging for another system to be installed that would further reduce the risks of falls.
People were supported with positive risk taking. For example, 1 person was choosing not to follow health professional guidance. The service had involved the health professional who had initially reviewed the person and agreed the level of support required to reduce any risks.
Some risk assessments did not include details of all of the control measures in place. We discussed this with the registered manager who told us they would include the details in the risk assessments.
 

The service detected and controlled potential risks in the care environment.
There were a range of health, safety and environmental checks in place, these included checks on equipment, water, fire, gas and electric. The checks on the water temperatures indicated hot water in 2 people’s rooms was higher than the recommended safe maximum temperature. The registered manager confirmed these people would not independently use the water outlets, however there were no risk assessments detailing the control measures in place to protect people and staff. The registered manager assured us the relevant risk assessments would be implemented.
We discussed the hot water temperatures with the provider who told us they had completed extensive works on the water system to ensure they were running at safe temperatures. They also told us the further improvement work they had planned for the water system.
The provider had an action plan detailing all the work required on the building and they could evidence the progress they were making.
There were fire safety checks completed by external contractors. The provider was working through the improvements identified by these checks. There had been a slight delay due to the provider not being able to locate their asbestos register. They arranged for another asbestos assessment to be carried out with assurances provided once this had been completed the required fire safety improvements would be completed.
 

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.
Most people told us there were enough staff available. One person told us, “I think that they have enough staff.” Another person commented, “They [staff] are all marvellous. Anytime day or night I can ring my call bell and they will come fairly quickly.” One person told us on 1 occasion they had to wait a long time for staff to arrive. We discussed this with the provider who demonstrated the call response time was less than had been reported to us.
Most staff told us they thought there were enough staff available. One staff member told us, “I would say yes there are enough staff, shifts are covered 9 times out of 10.” Some staff told us they were busy at times particularly when staff were off sick. One member of staff commented, “Sometimes there are 2 [care] staff on in the morning, we can do it, it’s a push and the bells are consistent. We can’t help staff sickness, [name of registered manager] helps out if needed.”
The provider acknowledged that staffing and covering sickness had been a challenge, they were offering staff an incentive to pick up additional shifts. The provider told us they had increased staffing levels in response to the general decline in some people’s health.
Staff received a range of training to ensure they understood people’s needs. One staff member told us, “There is enough training to do the role, I really enjoy the face to face training.”
There were effective systems in place to ensure staff were recruited safely. Staff spoke positively about their support and supervision.
 

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading.
Staff followed infection prevention and control practices to reduce the risk of infection. Staff received infection prevention and control training and told us they had access to appropriate personal protective equipment (PPE).
The service was mainly clean. One relative told us, “It’s spotless. “However, we found 1 area in the laundry was not effectively cleaned. The registered manager told us it was the maintenance person’s responsibility to keep this area clean, and they assured us this would be completed. We also found some minor gaps in the kitchen cleaning records, so it was not possible to confirm if this area of the home had been cleaned in line with the cleaning schedule.
 

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.
People and relatives were happy with how people were supported with their medicines. One person told us, “I know why I am taking my medication and am given it timely.” A relative told us, “They are very on top of medicines.”
Medicines were stored securely and administered by trained staff. Medicines administration records (MARs) were completed, and protocols for ‘when required’ medicines were in place. Where people required creams or ointments to be applied by staff topical MARs were in place. We identified 1 tube of cream that had not been dated when it was opened. It is important to date creams when they are opened to ensure they remain effective. The registered manager told us they would address this.
Medicines were administered as prescribed. Fire risk assessments for flammable emollients were in place. Regular medicines audits were completed to ensure people’s welfare and safety.