Townfield and Coach House

The registered manager had established effective infection prevention and control procedures which were understood and followed by the staff. The registered manager had introduced a screening process for visitors when entering the building, which included health and temperature checks as well as the provision of personal protective equipment (PPE). Two visitor pods with external access had been built in the grounds, which were designed to facilitate visits from friends and family members.

Admission to the home was completed in line with COVID-19 guidance. People were only admitted following a negative COVID-19 test result and supported to self-isolate for up to 14 days following admission to reduce the risk of introducing infection. The registered manager explained people’s health and well-being was carefully monitored during this time.

There were plentiful supplies of PPE and stocks were carefully monitored. Staff had been trained in infection control practices and posters were displayed throughout the home to reinforce procedures. We observed staff were using PPE appropriately. There were sufficient staff to provide continuity of support should there be a staff shortage.

The layout of the service and the communal areas were suitable to support social distancing. The premises had a good level of cleanliness and was hygienic throughout. Housekeeping and care staff were following an enhanced cleaning schedule and there was good ventilation. The atmosphere of the home was calm and peaceful, and we observed staff were attending to people’s needs.

The provider’s infection prevention and control policies and procedures were up to date and audits had been carried out on a regular basis. The provider also had a business contingency plan and had developed guidance and risk assessments in relation to the current pandemic.

At our last inspection in June 2016 the service was rated 'Good'. At the present inspection the service remained 'Good'. At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The home had a registered manager in post. 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.

People remained safe at the home. People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse. Staff had been trained in how to follow these procedures. Risk assessments were conducted and risk management plans were in place which enabled people to receive care with minimum risk to themselves and others.

The registered manager monitored accidents and falls in order that preventative measures were put in place to avoid reoccurrence and promote the safety of people who use the service, the staff and anyone visiting the home.

Staff had been supported to deliver care in line with current best practice guidance. People were able to eat and drink enough to maintain a healthy weight whist being provided with a balanced diet. People had access to healthcare services so that they received on-going healthcare support.

People were protected from the risk and spread of infection because staff consistently followed the provider's infection control procedures. The home was clean and free of unpleasant odours.

Equipment used to support people was clean, in a good state of repair and was regularly serviced.

Staff had been safely recruited and there were sufficient numbers of staff on duty to meet people's needs in a way which met their preferences and promoted their independence. People told us they felt safe in Townfield and Coach House. Staff had received training in the protection of adults and knew what action they should take if they suspected or witnessed abuse.

Staff knew people well and understood how to meet their needs. People's rights were protected. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. People and their relatives where possible had been consulted about their care and support needs which were assessed before they moved into the home. Care plans and risk assessments included information and guidance for staff about people's needs and how they preferred their needs to be met.

People were enabled to maintain relationships with their family and friends; visitors were made to feel welcome. People were encouraged to participate in organised activities and to go out on trips.

People's medicines were safely managed. We observed that people received their medicines wherever they felt most comfortable.

People's records were kept safely to maintain confidentiality.

The layout and decoration of the home met people's needs. The environment was adapted in order that people could freely move around without restriction or risk to their safety. A great deal of thought had been given to upgrading the environment in order that it promoted wellbeing whilst being dementia friendly, homely and attractive to people living there.

The home was well-managed. The registered manager communicated effectively with staff and relatives. They sought the views of people using the service, their relatives and friends through residents' meetings, relative’s forums and satisfaction surveys.

The provider had a complaints procedure in place and people said they were confident their complaints would be listened to and acted on. The registered manager had effective systems in place to regularly assess and monitor the quality of the service provided to people.

Townfield and Coach House is registered to provide accommodation and personal care for up to 28 people. At the time of the inspection there were 23 people living in the home. The service specialises in providing care for people living with dementia. People required a range of help and support in relation to their dementia and care needs. The home is located close to Great Harwood town centre and all local amenities. Accommodation is provided on two floors linked by a passenger lift, stair lifts and stairs. Communal space is available on the ground and first floor.

The service was managed by a registered manager. 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.

At the last inspection on 6 December 2013, we found the service was meeting the regulations which were applicable at the time. During this inspection we found the service was meeting the current regulations. However, we made a recommendation about further developing the environment to help people living with dementia to find their way around the home.

People living in the home said they felt safe and staff treated them well. Care delivery was supported by clear up to date care documentation which was personalised and regularly reviewed. Staff felt that training provided was effective and ensured they were able to provide the best care for people. Care plans and risk assessments had been completed to ensure people received appropriate care. These had been written using information sought from the person or their relatives if appropriate. This meant plans and assessments were person centred and reflected people's personal choices and preferences.

Medicine documentation and relevant policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing, checks and staff competencies were carried out to ensure high standards were maintained.

Staff received training which equipped them for their roles and supported them in providing safe care for people. Robust recruitment checks were completed before staff began work. Staff demonstrated a clear understanding on how to recognise and report abuse and treated people with respect and dignity.

People's mental health and capacity were assessed and reviewed with pertinent information in care files to inform staff of people's individual needs. People were encouraged to remain as independent as possible and were supported to participate in daily activities. People were given choices and involved in day to day decisions about how they spent their time. People were asked for their consent before care was provided and had their privacy and dignity respected. People's nutritional needs were monitored and reviewed. People were given a choice of meals and staff knew people's likes and dislikes. Healthcare referrals were made appropriately to outside agencies when required.

The registered manager took into account the views of people and their relatives about the quality of care provided through daily conversations, meetings and satisfaction surveys. The registered manager used the feedback to make improvements. Notifications had been completed to inform CQC and other outside organisations when events occurred.

All the people we asked said they enjoyed the meals. One person said, 'The food is lovely, she can cook as good as my mum.' People's weight was monitored and when necessary advice was sought from other healthcare professionals.

We found that the home was clean, warm and well maintained. People were encouraged to make their own rooms more homely with personal items such as photographs, ornaments and pictures for the wall.

We noted that recruitment procedures were thorough in order to protect people from the employment of unsuitable staff.

We noted that systems were in place to monitor the quality of the service provided. There was evidence to demonstrate that people were regularly consulted about the care and facilities provided at the home.

We found that suitable arrangements were in place for the safe keeping and handling of medicines.

People using the service said there was enough staff on duty to meet their needs. We saw that staff responded promptly when people asked for assistance.

We saw that appropriate and accurate records were kept for people using the service and the overall effective management of the home.