Tower View Residential 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 good. At this assessment, the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The service manager told us there had not been many incidents and accidents recently. Any incidents they had were recorded and reviewed appropriately. Learning from incidents was shared with the staff team through team meetings. For example, 1 person had experienced a decline in their emotional wellbeing. Staff had discussed this person in staff meetings to agree how best to support them to ensure they were able to provide consistent support.

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. People were supported to attend health appointments at their local hospital. Professionals shared there was 1 person who needed regular treatment at the local hospital. Staff ensured the person attended as required. Staff were able to seek support from colleagues at Tower House to support the person to attend their appointments.

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.

We saw people were being supported by staff that knew them and understood how best to support them. Staff had received safeguarding training and demonstrated a knowledge of safeguarding policies and procedures. They could explain what steps they should take to raise concerns both with the provider and with the local authority No-one was subject to any Deprivation of Liberty Protection safeguards (DOLS) at the time of the inspection. However, staff had received appropriate training and could demonstrate they understood the steps needed if someone did lose capacity. We saw people were relaxed when staff were supporting them

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them.

Two people told us they would like to learn to cook their own meals but were only able to use the cooker if there were staff present for safety reasons. We saw people were provided with meals by Tower House, a service close by that is part of the Dunraven group, at lunch and teatime. This meant people did not have the opportunity to develop independence skills because of possible risks to themselves.

People’s personal evacuation plans (PEEPs) stated people could seek help from Tower House using their mobile phones. The PEEP’s had not considered people did not or could not use their phones. We spoke to all 3 people who said they would walk across to Tower House if they needed help in the event of fire. Further, records demonstrated there had never been no nighttime evacuation practices. This meant the provider could not be assured people’s PEEPs accurately reflected their response to a fire which put people at risk of avoidable harm.

At the time of the inspection here was no onsite staff support for people over night. People were directed to contact Tower House using their mobile phones should there be an emergency. The provider had a risk assessment relating to this which included people ringing for assistance should they need it. However, it did not identify that people’s mobile phones did not always work, and they had to walk across to Tower House. Although people had not experienced any harm, it meant that there was an avoidable delay for people to get help which put them at higher risk of harm.

However, staff could describe how to support people to mitigate some of the risks they faced.

People had activity risk assessments which ensured risks were considered. At the time of the inspection people were well but some people experienced fluctuating wellbeing which could impact on their safety. Whilst this was not recorded in risk assessments staff we spoke to could describe the steps they would take if people were experiencing a fluctuation and how this might increase risks to people.

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

People told us the lounge was very cold, and they did not want to use it because of this. This meant people could not use the main communal space in their home. During the inspection inspectors noted the lounge was cold. There was a fire in the lounge but this had been decommissioned meaning it could not be used to provide extra heat during cold spells. Further, the lighting was poor in the lounge. As this inspection was completed in winter the lounge was very dark for large periods of the days.

We spoke to the provider about the concerns found in the lounge and the stated they would address this. When we returned for a second visit, we saw several changes to the lounge had been implemented including ensuring the lighting was working, closing windows, and moving the furniture around to make the lounge cosier. However, the lounge continued to be cold.

The provider made sure there were enough qualified, skilled, and experienced staff. They worked together well to provide safe care. However, at times they did not meet people’s individual needs.

Staff were being recruited safely and in line with current best practice. We saw new staff had induction when they started. All staff were receiving supervisions although the records we reviewed showed a lack of detail relating to what was discussed during the supervision. Staff told us the service manager was approachable, and they could raise issues with them outside of supervision and team meeting.

Staff told us they had received regular mandatory training and further developmental training. They felt their training was appropriate and enabled them to deliver safe care.

The provider had a rota of staff allocated to oversee the service, but they were not present in the service when people were there despite being commissioned to deliver a 24-hour service. This meant people were not receiving their commissioned hours of support to enable them to develop their skills to move on to more independent environments.

People told us they felt they could have more staff around at time as this would enable them “to do more things” This was addressed by the local authority and the provider during the inspection. The provider changed their staffing to ensure staff were present when people were home and overnight.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading.

The provider ensured a cleaner visited the house weekly to keep it clean. We saw the home was clean and well presented.

Staff we spoke to understood the need to wear appropriate personal protection equipment (PPE) when supporting people with medicine and personal care.

We saw 2 items of food that were out of date and a pudding in the fridge that had not been labelled. We addressed this with the provider who ensured they were removed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff involved people in planning, including when changes happened.

People’s medicines were stored safely either in their own rooms or in the staff room. Staff had received the appropriate training in administering medicines and kept accurate records of administration. One person was working toward more independence with a plan to move to a supported living environment. They were in the process of taking their medicines independently.