Turnpike Court Residential Care Home

Turnpike Court is ‘care home’ without nursing which accommodates up to 53 people across 2 separate units, each of which have separate adapted facilities. At the time of the inspection there were 47 people receiving a service.

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

We received mix responses from people and relatives regarding staffing levels. The provider was able to demonstrate a dependency tool which assessed the number of staff needed. During the inspection we saw people requiring care, but staff were busy which delayed time to response to people care needs immediately. We discussed this with the registered manager and have made a recommendation about monitoring how staff are deployed across the service in line with people's dependency.

Although processes were in place to assess people under the principles of the Mental Capacity Act (MCA) we found that the service was not always working in line with this and recommended the provider reviewed information held on people.

People gave mixed responses on opportunities to discuss feedback with management and we have made a recommendation the provider reviews how outcomes from meetings are shared with people.

People were positive about the care and support they received. People were treated with dignity and respect by staff knowledgeable about the person and their support needs.

Relatives felt their loved ones were safe living at the service and where confident people's needs would be meet. People described positive relationships with staff and senior leaders at the service.

Staff recruitment processes were followed. Staff received training appropriate to their role, with on-going training given.

Visiting professionals spoke approvingly regarding the staff team and the knowledge they have of the people living at the service.

Staff spoke positively about working at Turnpike Court and felt well supported by the management team.

The registered manager was open and proactive to any queries we raised during the inspection and took appropriate action to mitigate any risks to people.

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 27 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

Recommendations

We made recommendation about how staffing is deployed across the service. Further recommendations to review systems for documentation relating to the Mental Capacity Act and how feedback following meetings with people who use the service is shared with them.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ Relatives spoke positively about the home including communication during the pandemic. Comments included; “We get regular telephone calls from staff with updates about [Name]" and “The health and safety at the home is absolutely spot on".

¿ Relatives told us they had previously participated in garden visits and inside visits with screens in place. They said these were pre booked and well managed.

¿ All visitors were asked to complete a health screening form, have their temperature checked and were provided with face masks to wear throughout their visit. Full personal protective equipment (PPE) was available for all visitors along with access to handwashing facilities and hand sanitiser.

¿ The service had received lots of compliments during the pandemic including; "Thanks to all the staff for all you are doing in these difficult times, and for looking after [Name] and "The care, selflessness and love you give our relative reminds us all about what is important in these challenging times."

¿ The service had increased the cleaning schedules and routines to reduce the risks of cross infection. The environment was very clean and hygienic.

¿ We observed staff to be wearing the correct personal protective equipment (PPE) throughout the inspection.

¿ People and staff were taking part in regular COVID19 testing.

¿ People had individual risk assessments in place that reflected their specific needs in relation to COVID19.

¿ Staff had all received training to meet the requirements of their role and for the management of COVID19.

Further information is in the detailed findings below.

We had previously inspected the home on 26 July 2017, when it was under a different provider. The home was registered under a new provider on 30 October 2017, however the registered manager and other staff remained the same. This was our first inspection since the location had been re-registered with us.

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

Turnpike Court accommodates up to 53 people across two separate units, each of which have separate adapted facilities. One of the units had recently opened following a refurbishment of the home. At the time of the inspection there were 35 people receiving a service.

There was 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.

The registered manager was unavailable during the inspection. The quality compliance manager was currently supporting the home in the registered manager’s absence.

Overall people were positive and complimentary about the service.

We found minor shortfalls in the safe management of medicines. There were some issues relating to the accurate recording of the support people required with medicines. The compliance manager acted promptly to address the issues raised.

There were sufficient staff to meet people's needs. There were some mixed views about the timeliness of staff responses. The management team regularly reviewed staffing levels. Recruitment of new staff was underway and staffing levels were due to be increased. The provider followed safe recruitment practices.

Risk assessments were in place which covered topics such as moving and handling and risk of falls. Action taken to assess and manage risks had not always been clearly recorded.

Staff understood their responsibility to protect people from abuse and harm. The provider had policies in place for safeguarding vulnerable adults and whistleblowing. Staff we spoke with had an understanding of the signs of abuse and knew how to report any safeguarding concerns.

The home was clean and well maintained. We noted some potential environmental health and safety risks which were dealt with immediately during the inspection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by staff who were suitably trained and supervised.

People's nutritional and healthcare needs had been assessed and were met. People were positive about the food on offer and staff supported people to have sufficient to eat and drink. Staff were responsive to changes in people’s physical and mental health needs.

We observed that staff had developed caring relationships and treated people in a kind and compassionate manner. People told us that they were treated with dignity and respect.

People received care that was centred around their individual needs. People spoken with confirmed their choices were respected.

Most aspects of the care plans we viewed were detailed and reflected people’s individual likes and preferences. However, we noted occasional gaps in the information contained and some did not contain as much detail as others.

Work was underway to support staff to ensure life plans contained up to date information, including individual consultation with people about their preferences.

People could take part in person-centred activities and were encouraged to maintain hobbies and interests. The activities coordinator provided a variety of activities and entertainment for people.

We found the provider was proactive in monitoring the service and taking action to address any areas for improvements. Most of the issues raised during the inspection had already been identified and action was underway to address these areas.

There was a system in place to gain views from people and relatives on their experience of the care provided.