We carried out an unannounced comprehensive inspection of Turret Villa Retirement Home in September 2015. We identified a breach of regulation 12, safe care and treatment in relation to the management of medicines. We rated the service as good.Turret Villa Retirement Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home can accommodate up to 35 people. There were 24 people living at the home at the time of the inspection.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.
We found continuing shortfalls in the management of medicines. Risks relating to the premises and equipment had not always been assessed.
Safeguarding procedures were in place. No one raised any safeguarding concerns. Systems to monitor people’s monies however, were not always documented.
There were sufficient staff deployed. Staff carried out their duties in a calm unhurried manner. Recruitment checks were carried out prior to staff working at the home to ensure they were suitable to work with vulnerable people.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. We found omissions in the maintenance of records relating to the MCA. People told us consent was sought before care was carried out. However, records were not always maintained to evidence this or to demonstrate that staff had followed the principles of the MCA.
There were omissions and shortfalls in the maintenance of records relating to people’s care. We did not identify any major impact of these omissions and shortfalls upon people’s health, safety and wellbeing. People told us they received good care. However, we considered that an effective system was not fully in place to ensure people’s care plans were accurate and reflected their needs.
People told us they were generally satisfied with the meals at the home. Some of the gentlemen told us that larger portions would be appreciated. We observed the lunchtime experience and saw that staff were attentive to people’s needs.
Staff worked with various agencies and accessed other services when people's needs had changed, for example, consultants, GPs, speech and language therapist, dietitians, the chiropodist and dentist.
We found that not all aspects of the environment met best practice guidance relating to supportive environments for people living with dementia. We have made a recommendation about this.
People, relatives and health and social care professionals told us that staff were caring. Many of the staff had worked at the home for a considerable number of years. This meant that people were supported by staff who knew them well and could respond in a person centred way.
People living at the home had formed friendships with each other. Staff supported these friendships.
People told us they were encouraged to be as independent as possible and were able to move around the home freely. Several people self- administered some of their medicines. One person enjoyed getting a taxi to visit their relative in Berwick.
People and relatives told us that staff promoted people's privacy and dignity. We observed that staff knocked on people's doors before they entered and spoke with people respectfully.
We found shortfalls in certain aspects of the service. This included omissions in the monitoring of health and safety, medicines, people’s monies, the MCA, training and care plans. These issues had not been highlighted by the provider’s quality assurance system. Despite these issues, we did not identify any major impact upon people’s health, safety and wellbeing. People and relatives were very positive about the care home.
Staff told us they enjoyed working at the home. We observed that this positivity was reflected in the care and support which staff provided throughout the inspection.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to good governance.