Background to this inspection
Updated
1 December 2020
The inspection
We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received via a whistleblowing about the management of the service and the safety of people who used the service. A decision was made for us to inspect and examine those risks.
During the inspection, we made the decision to widen the scope of the inspection to become a focused inspection which included the key questions of safe, responsive and well-led.
Inspection team
The inspection was carried out by one inspector, an assistant inspector, and a member of CQC’s medicines team who visited on the second day of the inspection. An Expert by Experience undertook telephone interviews with people and 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
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
The service had a manager who is in the process of applying to be 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 reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We spoke with five people who used the service and five relatives of others about their experience of the care provided. We spoke with the manager, the regional business manager, the compliance manager and five care workers.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, and quality assurance records.
Updated
1 December 2020
About the service
Turnberry Court is an extra-care sheltered housing service providing personal care and support to people living in their own flats. It provides a service to adults with a range of needs, such as dementia, mental health and those living with a learning disability. The service provides 38 one-bedroom and two two-bedroom flats within one building. There were 32 people using the service at the time of our inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
We received mixed feedback from people who used the service and their relatives. While most people were happy with the service, some raised concerns that staff did not always respect their wishes or meet their needs. Some thought not all staff had the necessary skills to support them.
There were systems for monitoring the quality of the service, gathering feedback from others and making continuous improvements. However, the provider's monitoring systems had not identified some of the shortfalls we found on the day of our inspection, and further improvements were needed. The provider was responsive to our feedback and took immediate action to make the necessary improvements.
Improvements had been made since the last inspection in relation to risk management. We saw risks to people’s safety and wellbeing were assessed and appropriately mitigated. People received their medicines safely and as prescribed.
People were supported to remain as independent as they could and were encouraged to engage in activities organised at the service. Most felt consulted in all aspects of their care and support and felt listened to.
People’s needs were assessed before they started using the service and care and support plans were developed from initial assessments. Care and support plans were regularly reviewed and updated as people’s needs changed.
Staff felt happy working for the service and were supported by their manager. They received the training, support and information they needed to provide effective care. There were robust procedures for recruiting and inducting staff to help ensure only suitable staff were employed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence
The management and staff team worked closely with people who used the service to help ensure they continued to feel confident. They supported and encouraged people to maintain their independence and undertake activities of their choice.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
The provider ensured each person moving into the service was involved in a meeting to discuss their needs and how they wished to be supported. The management and staff promoted person-centred care and people and those who knew them best were involved in their care planning and reviews.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
Staff received training about how to support people with a learning disability as part of their induction. This helped them support people effectively in line with their wishes and needs. People who used the service were provided information in a range of formats, including easy read, to help them understand important information and guidance.
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 20 November 2019) and there was one breach 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 undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the management of the service and the safety of people who used the service. A decision was made for us to inspect and examine those risks.
During the inspection, we made the decision to widen the scope of the inspection to become a focused inspection which included the key questions of safe, responsive and well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
Follow up
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.