Trowbridge Oaks Care Home

Updated 29 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by three inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Trowbridge Oaks Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experiences of the care provided. We spoke with six members of staff, the deputy manager and regional director. We reviewed a range of records including seven people’s care records, multiple medication records and records relating to the management of the service. We also looked at three staff files in relation to staff recruitment.

After the inspection

We organised to speak with a further six people over the telephone and 10 relatives about their experiences of the care provided. We also spoke with four members of staff and the deputy manager. We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures and quality assurance records. We contacted the local Healthwatch for feedback from the public about this service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Updated 29 October 2021

About the service

Trowbridge Oaks Care Home provides personal and nursing care for up to 52 people. Accommodation is provided over two floors accessed by a lift and stairs. People had their own rooms and there were communal rooms such as lounges, dining areas and a garden accessed from the ground floor. At the time of inspection there were 43 people living at the service.

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

At our last inspection we found that people who lacked capacity did not have consistent records in place to demonstrate decision making. At this inspection we observed this had improved. 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 were living in a clean home that was well maintained. Windows were left open where possible and appropriate for additional ventilation. Chairs were spaced out to support social distancing and additional staff rooms had been created so staff could have their breaks safely.

People and staff were testing regularly for COVID-19 in line with government guidance. All visits to the home were pre-booked in advance and all visitors were screened. For example, staff checked visitors’ temperatures and asked screening questions about COVID-19 symptoms. Any visitor to the home also had to complete a Lateral Flow Test (LFT) prior to being able to go into the home.

Staff had been trained on safe infection prevention and control practice and we observed staff to be working in a safe way. Staff wore the correct personal protective equipment (PPE) and had specific areas in the home where they could put on fresh PPE when needed. The provider had plenty of PPE stock available.

The provider was carrying out monthly infection prevention and control audits to monitor safe systems of work. The regional director told us this was increased to weekly and daily if there was any concern or any positive cases of COVID-19. In addition, there were other quality monitoring systems in place to drive improvement and monitor quality and safety.

People had timely referrals to healthcare support they needed, and records were in place to monitor any action taken. Staff were supported by a range of healthcare professionals from the local community.

People told us they enjoyed the food on offer and had a choice of both food and drinks. Mealtimes were relaxed with staff providing support where needed in a person-centred way.

People’s risks were identified, assessed and recorded in their care plans with management plans in place. These were reviewed regularly by staff and updated when required. People’s needs were assessed prior to admission and staff used tools to continue assessments regularly. Staff attended handovers so they could keep up to date with people’s needs and any changes.

During our inspection we observed there were sufficient numbers of staff available although the service had experienced challenges with staff shortages. Action had been taken to try and obtain agency staff and the provider was looking at various ways to improve recruitment. Staff had been recruited safely.

People had their medicines as prescribed. Prior to our inspection we received information of concern about medicines management. We found staff had taken action to address shortfalls identified.

People were supported by staff who were trained and supported by the management and provider. Staff had access to resources to support their well-being. People and staff told us the service was well-led and the management were visible and approachable. There was a registered manager in post who made sure regulatory responsibilities were actioned.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 7 September 2019).

Why we inspected

We received concerns in relation to management of medicines and how people were being cared for. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

We found no evidence during this inspection that people were at risk of harm from the concerns. Please see the safe, effective and well-led sections of this full report. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Trowbridge Oaks Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.