19 June 2021
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.
This inspection was carried out by two inspectors and a nurse specialist professional advisor (SPA). An Expert by Experience also assisted by carrying out telephone calls to people living at the home and their relatives. 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
Turner Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (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 checked the information that we held about the service. This included statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law. We also gathered feedback about the service from the local authority. We used all this information to plan our inspection.
During the inspection
We spoke with five people who lived at the service and seven relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, director of operations, quality and compliance staff, nurses, care workers and other staff.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at four staff files in relation to safe recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
19 June 2021
About the service
Turner Home is a residential care home providing accommodation, personal and nursing care for up to 59 people. The home supports people with mental and physical health conditions, including dementia. There were 52 people living at the home at the time of this inspection.
People’s experience of using this service and what we found
At our last inspection the provider had failed to ensure medicines were safely managed, effectively manage the risks associated with people’s care and implement robust processes to monitor and improve the safety and quality of care being provided. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
People received their medicines safely and as prescribed. Changes had been made to the home’s medicines dispensing and administration processes to ensure medicines were stored securely. Quality assurance processes around medicines administration had also improved. People had personalised risk assessments which gave staff the information needed to safely manage the risks associated with people’s care. However, the consistency and quality of health and care monitoring records still required improvement. The environment was safe and well-maintained. The home was clean and effective infection prevention and control measures were in place.
People told us they felt there were enough staff at the home. One person said, “There are always plenty of staff around even at weekends and at night. If I use the buzzer, I get help quickly.” The home was reliant on some agency staff, potentially making it more challenging to deliver and sustain improvements, such as maintaining consistent and high-quality records. Staff were visible around the home and were readily available to support people when needed.
People were safeguarded from the risk of abuse. People told us they felt safe living at the home and relatives felt the same. One person said, “I feel safe here as the staff look after me well. If I need anything I just ask for their assistance.” Staff had received safeguarding training and were aware of their responsibility to report safeguarding concerns. The provider had systems in place to manage concerns of a safeguarding nature.
Quality assurance and audit processes had improved since the last inspection. However, further improvements were still needed. For example, greater clarity was needed about who was responsible for ensuring highlighted actions were completed and in what timescale they were due to be completed.
People living at the home and their relatives gave positive feedback about the staff. One person said, “The staff look after me very well they do everything for me. The staff talk to me very nicely, they are polite.” Relatives said staff kept them well-informed and involved in their relative’s care. One relative commented, “The staff often chat with me and they tell me what [Relative] has been doing. If there is a problem, they call me up.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 10 November 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced focused inspection of this service on 29 September 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance at the service.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
We also 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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Turner Home on our website at www.cqc.org.uk.
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.