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We are carrying out a review of quality at Tozer House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Good

Updated 8 April 2017

The inspection took place on 8 March 2017 and was an unannounced inspection.

At the last inspection, in January and February 2016, the service was rated ‘Requires improvement’. At this inspection, we found the service had made improvements. The three breaches of regulation concerning medicines management, quality assurance and the sending of key notifications to the Commission had been met.

Tozer House is a residential care home that provides support to a maximum of 15 people who have a range of learning disabilities and some who were living with dementia. The home comprises two houses, Rosemead and Bramley, where people live and a third building with the communal dining area and offices. The buildings are situated around a garden area. The home is located within walking distance of Chichester town centre. At the time of this inspection there were 12 people living there, some on a temporary basis.

The service had a new registered manager. They started in post in October 2016 and were registered with the Commission in December 2016. 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.

The provider and registered manager had overseen improvement at the service. There were systems in place to monitor the quality of the service delivery and to drive improvement. Action plans were in place and monitored to ensure that necessary changes were implemented. Records relating to staff training and supervision were in place and up-to-date.

Medicines were managed safely. New systems were in place to ensure that people received their medicines as prescribed. Staff who administered medicines had received training and their competency was assessed. Systems were in place to monitor the administration of medicines and to pick up any omissions or concerns.

The registered manager had notified the Commission of important events as required by law. We discussed the various notifications that services are required to send to the Commission. The registered manager demonstrated a clear understanding of her responsibilities in this area.

Feedback from people, relatives and staff about the service was very positive. People told us they felt safe, that they enjoyed support and friendship from a regular staff team and that they were regularly asked for their views and opinions. Staff felt supported and told us their ideas and opinions were valued by the management team.

People told us staff treated them respectfully and said there were enough staff on duty to assist them. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed.

People had developed good relationships with staff and had confidence in their skills and abilities. There was an established team of staff at the home, which offered continuity of care for people. Staff had received training and were supported by the management through supervision. Staff were able to pursue additional training which helped them to improve the care they provided to people.

People enjoyed a variety of home-cooked food. Staff were aware of people’s dietary needs and preferences and adapted the menu accordingly.

People were involved in planning their care and staff understood what was important to them. Each person had a keyworker who took the lead in supporting them and coordinating their care.

Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff supported people to be as independent as they were able

Inspection areas

Safe

Good

Updated 8 April 2017

The service was safe.

People received their medicines safely.

Risks to people were identified and assessments drawn up so that staff knew how to care for people safely and mitigate any risks.

People said they felt safe. Staff had been trained in safeguarding so that they could recognise the signs of abuse and knew what action to take.

There were enough staff to meet people’s needs and keep them safe.

Effective

Good

Updated 8 April 2017

The service was effective.

Staff had received training to carry out their roles. They were supported through regular supervision.

Staff understood how consent should be considered and supported people’s rights under the Mental Capacity Act.

People were offered a choice of food and drink and supported to maintain a healthy diet.

People had access to healthcare professionals to maintain good health.

Caring

Good

Updated 8 April 2017

The service was caring.

People received individualised care from staff who cared and who knew them well.

People were involved in making decisions relating to their care and were supported to be as independent as they were able.

People were treated with dignity and respect.

Responsive

Good

Updated 8 April 2017

The service was responsive.

People’s care was planned and monitored to promote good health.

Staff understood how to support people and responded quickly to any changes in their health.

People were encouraged and supported to spend their time and engage in pursuits that interested them.

People knew how to make a complaint if necessary and were confident any issue would be addressed.

Well-led

Good

Updated 8 April 2017

The service was well-led.

The culture of the service was open and inclusive. People and staff felt able to share ideas or concerns with the management.

People and staff spoke highly of the registered manager. Staff told us they were listened to and felt valued.

The registered manager and provider used a series of audits to monitor the delivery of care that people received, to ensure that it was consistently of a good standard and to make improvements.