Turret Villa Retirement 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 as requires improvement. At this assessment the rating has remained as requires improvement.

The provider was no longer in breach of legal regulation in relation to safe care and treatment as identified at the last assessment however; a new breach was identified at this inspection in relation to premises and equipment.

This meant some aspects of the service were unsafe and there was potential for people to be at risk of harm owing to issues identified with fire safety equipment and emergency escape routes.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt when things went wrong, and this was shared with staff to continually identify and embed good practice.

Refresher training and debriefs took place following an incident to ensure best practice would be followed in future. The manager had oversight of any safety concerns that occurred. Staff told us they felt confident to speak up if anything went wrong so that it could be corrected accordingly. People and relatives told us they knew how to raise concerns and felt confident appropriate action would be taken to address them.

Staff told us they received the appropriate training to be able to undertake their roles effectively. One staff member said, “The training we have is really good and a mixture of face to face here and online too.” Another staff member told us that they felt, “Listened to and valued,” when they offered reasonable adjustments.

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.

Care records evidenced people had access to a range of health and social care professionals when needed, including district nurses, GPs and dentists. Initial assessments were documented in individual files and this information aided care plan development.

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 were safe from harm and abuse. Safeguarding processes were in place to record concerns and notifications to the local authority and CQC were made appropriately. Safeguarding training formed part of the induction for new staff and within ongoing supervision with staff. Staff demonstrated a clear understanding of their responsibilities. People and relatives told us staff treated people well and people felt safe at the service.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place and contained person-centred information. Staff told us they knew people well and how best and safely support individuals. Risk assessments were clear and had been improved since the last inspection. Some risk assessments could be more detailed.

People told us they felt safe with the care being provided, and daily records evidenced people were being supported safely.

The provider did not always detect and control potential risks in the care environment. They did not make sure that equipment, facilities and technology supported the delivery of safe care.

The environment was homely; people’s bedrooms were personalised and designed to meet people’s needs. People told us they liked their bedroom areas and felt the overall environment was decorated nicely and well maintained.

There were policies and processes to ensure people were kept safe and staff knew what actions they needed to follow to ensure this. However, the fire alarm system was not appropriate for a care home based on current legislation. This had been identified through a fire risk assessment and fire alarm maintenance checks, but no action had been taken to change the system and bring this up to the required standard. The fire alarm did work, and some risk had been mitigated by the regular undertaking of fire evacuation drills.

The fire risk assessment and a visit from the fire service had identified issues with emergency exits on uneven ground, which could have made evacuation for people with mobility issues difficult. No action had been taken to rectify this issue. Following the inspection the provider confirmed they would be carrying out the required works as soon as possible.

The provider did not always make sure staff received mandatory training, however there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The registered manager was not aware of the requirement for care staff to be trained in learning disabilities and autism, in line with the governments preferred and recommended training on learning disability and autism. This meant staff had not received the training. At the time of the inspection there no people with a learning disability or autistic people living at the service. The registered manager took swift action to implement the training following the inspection.

Staffing levels were safe with a good skill mix per shift. There were processes in place to safely care for people in the event of absences.

People told us they received care and support from the same staff members, and felt staff were trained and knowledgeable enough to meet their needs. One relative told us, “They [staff] are (well trained), all the ones I know are good “. Another relative told us, “I feel that they are well trained.”

The provider followed safe recruitment systems and processes.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Personal protective equipment (PPE) was made available to staff. Staff had received infection prevention and control (IPC) training. People and relatives confirmed staff wore the appropriate PPE. The management team undertook IPC audits to maintain good IPC compliance.

The provider did not always make sure medicines and treatments were safe and met people’s needs, capacities and preferences.

Systems were in place to make sure people’s medicines were administered safely. Stock mainly balanced with records. Medicines that needed to be given at specific times were given correctly. People’s medicines allergies were recorded accurately.

We observed medicine administration to two people; staff were respectful, and people were given the time they needed. There was a process for people to receive medicines when away from the service.

Some medicines care plans and ‘when required’ medicine protocols lacked detail or contained conflicting information. Guidance was not in place for all creams applied by care staff as part of personal care and some records were incomplete.

Medicines were stored securely including controlled drugs. Temperatures were recorded for the medicine rooms and fridges; however, the fridge temperature had been out of range and had not been investigated to ensure medicines were safe to use.

Audits had improved since the last inspection and had picked up some of the issues we found.