Tower View Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment, the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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 did not always make sure people’s care and treatment was person centred because they did not always effectively check and discuss people’s health, care and wellbeing needs with them.

People were having regular reviews of their needs. However, these were not always effective as leaders were not identifying what people wanted to do. For example, 1 person told us they wanted to do more activities in the community relating to their hobbies, however. this was not reflected in their needs assessments. They also shared they wanted to have internet within the house so they could access sports TV channels to watch the sports they enjoyed. This meant people were not always able to access activities of their choice. We spoke to leaders about the wish of the individual to have internet and they agreed to ensure this was installed into the house.

However, people had had an assessment of their needs before moving to the service. The service manager ensured they met with people to review their needs regularly. People told us they were involved in these reviews, and they felt listened to by the manager. Records demonstrated people received regular reviews of their needs, however not all needs people told inspectors about and been captured during their reviews.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. The provider had not ensured support was provided in line with current national standards including Right Support Right Care Right Culture.

The purpose of the service was to support people in recovery to develop skills to move to more independent support. However, the provider did not always ensure that people were developing their skills appropriately and with the aim of recovery and moving on as the focus. For example, people were not engaged with in relation to managing the home, including completing cleaning, and cooking tasks. People told us they were not encouraged to complete their own laundry, and we observed all laundry was put in a house basket and washed together. This meant their support was not focussed on recovery and developing skills to move on which was the purpose of the house. Further, two people we spoke to told us they would like to do more within their home to develop their independence.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People told us they were supported by staff who reminded them when they had to go to appointments. One professional we spoke to said staff were knowledgeable and supportive. They ensured people received the engagement they needed from professionals involved in their support.

The provider supported people to manage their health and wellbeing to maximise their independence, choice, and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us they were supported to access health professionals, including the GP and mental health services. Staff supported people to attend appointments.

Professionals told us staff were involved in reviews of support and treatment.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent. They did not always engage with people to ensure they were continuously supporting them to develop and improve skills that would ensure their outcomes were improved.

The provider was reviewing peoples care plans and outcomes with them regularly, but this was not always effective. For example, people told us they wanted to do more things but that they were not always able to. This included cooking meals in the home.

However, one person had been supported to re-engage with their voluntary work after a period of ill health and stopped them from being able to continue to commit to their job.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider had completed mental capacity assessments for people and had assessed them a as having capacity to make decisions in all areas of their lives.

However, this conflicted with the information in their care and support plans. For example, 1 person’s record showed that when they were unwell, they could get confused and not be able to understand what was happening. Another person had times when their health was poor and record showed at these times their capacity was compromised.

People’s mental capacity assessments did not identify or mitigate episodes of poor mental health. The provider stated they were aware of people’s fluctuating capacity and shared 1 document which stated if people ever lacked capacity they should complete a best interest’s decision on their behalf. However, records seen by inspectors did not demonstrate consideration had been given to supporting people when their capacity fluctuated. For example, there was no record of agreeing with people to delay decisions until they were able to make the choice for themselves.

Staff had received the relevant mental capacity training but told us assessments of capacity was something the manager completed. Staff understood the need to ask for consent when supporting people and people confirmed that this happened before staff helped them with any tasks. One person’s care plan clearly stated their support need in relation to a complex health issue. Staff demonstrated they understood the need to gain consent from them before they provided support.