- Care home
OSJCT Townsend House
All Inspections
20 January 2022
During an inspection looking at part of the service
People’s experience of using this service and what we found
Risks to people's safety and well-being were managed through a risk management process. On the day of inspection there were sufficient staff deployed to meet people's basic care needs. However, we saw staff were very busy and at times, rushed. We observed people not receiving timely support and staff told us they were task focused due to staffing levels. Whilst we found no evidence that people had been harmed, the staffing issues had an impact on the service running effectively. The registered manager was aware and the provider was actively recruiting.
Medicines were managed safely, and people received their medicines as prescribed.
People living at Townsend House were supported to lead purposeful lives, engaging with their families and the local community. Whilst adjustments had been made due to the restrictions of the Covid-19 pandemic, measures had remained in place to ensure meaningful relationships and people's overall health and wellbeing was maintained.
People told us they felt safe living at the home. Staff knew how to identify and report any concerns. Staff had been trained and were aware of their responsibilities to report concerns.
Staff worked well with external social and health care professionals. The service had a clear management and staffing structure in place and staff worked well as a team.
Rating at last inspection
The last rating for this service was Good (published 31 January 2020).
Why we inspected
We undertook a 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 staffing levels. A decision was made for us to inspect and examine those risks.
We inspected and found there was a concern with staffing levels, so we widened the scope of the inspection to become a focused inspection which included the key questions of Safe and well-led.
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 remains Good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Townsend House on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
9 January 2020
During a routine inspection
Townsend House is a residential care home, without nursing. At the time of our inspection the service was providing personal care to 40 people aged 65 and over, some of whom were living with dementia. The service can support up to 45 people in one purpose-built building covering two floors.
People's experience of using this service
Staff knew people extremely well which enabled them to respond to people’s needs and wishes at a personal level. People were treated as individuals and the service went the extra mile to grant people’s wishes and provide activities and experiences that met their individual needs. This enhanced their well-being and improved their quality of life. People spoke very positively about activities and the staff.
People told us staff were caring and kind. Staff's commitment and knowledge enabled people to receive care from staff who knew them well.
The registered manager and staff strived to provide safe care and support. The team worked with GPs and other healthcare professions to ensure the service responded to people's changing needs safely and effectively.
The registered manager continually looked for ways to improve people's lives. Staff culture was positive, and the team was caring. This had resulted in the provision of compassionate and personalised care. The service had a clear management and staffing structure in place. Staff worked well as a team and had a sense of pride working at the service. The provider had quality assurance systems in place to monitor the quality and safety of the service.
People received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff fully understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.
Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs and staff responded quickly to support people. Medicines were managed safely, and people received their medicines as prescribed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was good, published on 26 July 2017.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will return to inspect the service as per our re-inspection programme
22 June 2017
During a routine inspection
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated good:
People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.
People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's G.P's to ensure their health and well-being was monitored.
The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.
The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.
The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.
9 July 2015
During a routine inspection
This inspection took place on 9 July 2015. It was an unannounced inspection. At the last inspection on 26 January 2015 we asked the provider to take action to make improvements relating to people’s care needs, monitoring the quality of service, supporting people to eat and drink, people’s medicines, treating people with respect, staffing levels, supporting staff, records, and safety and maintenance of the premises. The provider sent us an action plan. At this inspection we found action had been completed and improvements made.
Townsend House is a care home without nursing in Oxford. The home cares for up to 45 older people. The home is run by the Orders of St. John Care Trust. On the day of our inspection 39 people lived at the home.
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.
People told us they were cared for by staff who knew their needs. Comments included; “They know what they are doing, no problem” and “They meet my needs perfectly. The carers know just how to help me”. Staff had received training and support to meet people’s needs.
Staff understood the needs of people, particularly those living with dementia, and they provided care with kindness and compassion. People spoke positively about the home and the care they received. They told us how staff took time to talk with them and provide activities such as and arts and crafts, games and religious services.
People were safe. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service reported concerns appropriately and ensured action was taken to protect people.
People received their medicines safely, as prescribed. Staff carried out appropriate checks before administering medicines in a sensitive and discreet fashion. Records were accurately maintained and all medicines were stored safely and securely.
Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe. For example, in relation to pressure damage or weight loss. This promoted people’s health and wellbeing.
The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision making on behalf of adults who may not be able to make particular decisions themselves. People’s capacity to make decisions was regularly assessed and staff demonstrated their understanding of the act in their day to day duties.
People told us they were confident they would be listened to and action would be taken if they complained or raised concerns. The service had systems to assess the quality of the service provided in the home and learning was identified and action taken to make improvements. This improved people’s safety and quality of life.
All staff spoke positively about the support they received from the registered manager. Staff told us they were approachable and there was a good level of communication within the home. People knew the registered manager and spoke to them openly and with confidence. The registered manager was visible about the home and spoke with people in a caring, familiar fashion.
26 January 2015
During a routine inspection
We carried out this unannounced inspection on 26 January 2015. The service is registered to provide accommodation for up to 44 older people who require personal care.
We previously inspected the service in November 2013. The service was meeting the requirements of the regulations at that time.
People were not always supported in a respectful way. Staff did not always know people well or respect their preferences in how they wanted to be supported. When people were listening to music in the lounge the television was switched on. The music was not switched off and this created a noisy environment. However, people told us they liked living at the home and were treated in a caring and friendly way. People and their relatives were complimentary about staff. People were supported with their personal care discretely and in ways which upheld and promoted their privacy and dignity.
People told us they felt safe and staff were knowledgeable about the procedures in place to recognise and respond to abuse. However, when people presented with behaviour that could be described as challenging, staff did not always respond in an appropriate way. Some people were not protected against the risk of developing a pressure ulcer because staff did not support them to use their pressure relieving equipment.
People were not always protected from risks associated with the environment because the carpet was in a poor state of repair in some places presenting a trip hazard. Doors to electric or storage areas were unlocked. These should have been locked to keep people safe. Some areas of the home were not clean.
Some people did not receive their medicines in line with their prescription. There were gaps and omissions in the recording of medicine administration and replacement stocks had not always been ordered before they had run out.
People liked the food. Mealtimes were relaxed and unhurried. However, people were not always supported to eat and drink enough and some records relating to nutrition and weight were not accurate, completed or reviewed.
Some people told us there were not enough staff to meet their needs and the rotas showed that target levels of staff had not always been achieved. People were not always cared for by suitably skilled staff who had kept up to date with current best practice because not all staff had attended training or received adequate supervision and appraisal.
People were involved in their care reviews and were supported to make decisions about their care. However, some care plans did not provide sufficient instruction to staff on how they should be supported. Where required, staff involved a range of other professionals in people’s care to ensure their needs were met.
The home had a manager in place who was in the process of registering with the Care Quality Commission to manage the service. Although the manager had some understanding of the changes and improvements that were required they did not always demonstrate good leadership skills. Quality monitoring systems to review the care and treatment offered at the home were not always effective. People, their relatives, visiting health professionals and staff recognised that improvements in the service were taking place.
Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions. Where restrictions were in place for people we found these had been legally authorised.
We found 9 breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see the action we took and what action we told the provider to take at the back of the full version of the report.
27 November 2013
During a routine inspection
People's needs were assessed and plans drawn up to meet their individual needs. We found that people were supported in accordance with these plans. One staff member told us "we're here to meet people's needs".
We found that staff knew how to report any concerns they had regarding people's safety and that the provider was able to respond appropriately in order to protect people.
People told us there were enough staff to meet their needs. We found that staff were trained and experienced and able to meet the needs of people supported.
We found the provider had in place systems to assess and monitor the quality of service provided. We were told of changes that had been put in place as a result of learning from accidents and incidents.
11 September 2012
During a routine inspection
Staff told us that they felt valued, that training, communication and support was good. They said that morale in the home was good.
We found that the service was compliant with the outcomes we looked at during this inspection.