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Town Moor House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 23 July 2019

About the service

Town Moor House is a residential care home providing care and support for older people. The service also provides support for people living with dementia. The service can support up to 28 people.

On the day of our inspection 26 people were using the service.

People’s experience of using this service and what we found

On the day of our inspection there were adequate numbers of staff available to meet people’s needs. However, deployment of staff was not effective. Agency staff were being used who did not know people. We looked at systems in place for recruiting new staff but found these were not always effective.

Medication systems were in place however, these were not always followed. Risks associated with people’s care and support had been identified, however, they lacked detail to ensure risks were managed safely. Staff understood safeguarding and whistleblowing procedures and would use them when required. Accidents and incidents were monitored, and lessons were learnt. However, one incident between two people was not reported.

Staff were knowledgeable about people needs, however, care was very task focused and institutionalised. Staff said training was good however, it was not clear if it was effective. Staff were supervised and supported. Staff felt the service was improving since the new manager had been in post.

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.

People received a balanced diet; however, people could be offered more support to ensure needs are met. People had access to health care professionals. The environment was not dementia friendly and there was limited accessible outside space. The outside space available was predominantly utilised as a smoking area for a small number of people who smoked.

When staff engaged with people they were mostly kind and caring. However, we observed some staff did not engage when providing support and were task focused. From care plans we looked at it was not possible to see it people were involved in their care planning. Staff we spoke with understood people’s needs however, did not always follow care plans to ensure they respected their choices. Care and support provided and observed was not person-centred.

We looked at care records and found they did not always reflect people’s needs. People did not always receive personalised care. People were listened to and complaints were appropriately dealt with and resolved. End of life care was included in the new electronic care plans to be used when required.

The service had an activities coordinator who was new in post and who was willing to learn to improve the quality of people’s lives but this is in the early stages. Care staff did not provide any social stimulation.

A new manager had been appointed and commenced employment at the service in March 2019. Audits were not always effective and had not always identified concerns raised on inspection. Although the new manager had acknowledged the shortfalls in the systems and was working with the provider to address them. The new manager was instilling positive values to improve the culture of service and one staff member told us, “The new manager is a breath of fresh air.”

People and relatives were involved in the service, quality questionnaires were sent out and regular meetings were held.

Rating at last inspection

The last rating for this service was requires improvement (published 26 July 2018). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside

Inspection areas

Safe

Requires improvement

Updated 23 July 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 23 July 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 23 July 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 23 July 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 23 July 2019

The service was not always well-led.

Details are in our well-Led findings below.