Towerhouse Residential Home

Updated 10 January 2023

The inspection

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.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Towerhouse Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. dependent on their registration with us. Towerhouse Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at information we had received from the provider in relation to the home. We spoke to a professional from a commissioning local authority. 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. We used all this information to plan our inspection.

During the inspection

We spoke with four people who lived at the home and one relative about their experience of the care provided. We spoke with four members of staff including the registered manager, the deputy manager, a care worker and the provider. We reviewed a range of records. This included four people's care records and multiple medication records. We looked at six staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

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.

Updated 10 January 2023

Towerhouse Residential Home is a care home providing care and support to people aged 65 and over. The home can accommodate up to eight people in one adapted building. When we inspected eight people were living at the home.

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

At our last inspection we rated the home inadequate. At this inspection we found the provider had made a number of improvements. However, we were not fully assured these improvements could be sustained over time.

The provider had improved their staff recruitment records. However, there was only one reference for a staff member, and for another we found a reference had not been verified to ensure it was genuine. Staff had received regular training and supervision to ensure they were equipped for their roles. However, some induction training records had not been ‘signed-off’ by a manager to verify that induction had been completed.

People’s medicines were safely stored and managed. Records of people’s medicines were up to date, and stocks were regularly monitored. People had personalised risk assessments that included guidance for staff to manage and reduce identified risks. The home and its garden were clean and tidy and free from trip hazards or other environmental risks. Bathrooms, fire doors, and garden paving had been renovated to a high standard.

People told us they enjoyed the meals provided

by the home and were offered choices about their food and drink. Support had been sought to ensure people with identified risk of choking when eating were safely supported. People had received support from health professionals where there were concerns about their health and well-being.

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.

Staff supported people in a caring and friendly manner, taking their needs and preferences into consideration. People spoke positively about the support they received from staff and management at the home.

People’s care plans were up to date. These included guidance for staff about how to support people in accordance with their needs and preferences. However, the care plan for one person contained conflicting information about their communication needs. Some activities took place at the home, but these were not always recorded in people’s records. The registered manager told us they were seeking to improve the range of activities available to people.

The provider had updated their quality assurance monitoring procedures. These covered a range of care and safety issues. A range of monitoring audits had taken place. However, these had been recently introduced, and were not yet embedded in the home’s practices.

People and staff spoke positively about the management of the home. Regular meetings had taken place with staff and people.

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

This service has been in Special Measures since 15 February 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

Enforcement

We have identified one breach in relation to staff recruitment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

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