Turnbull Close

Updated 22 February 2020

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 one inspector.

Service and service type

Turnbull Close is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since they registered with CQC. 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 two people, five staff and the registered manager. We observed the support people received using the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care and support plans and multiple medicines records. We looked at three staff files in relation to recruitment and supervision. A variety of records relating to the management of the service including checks, audits and policies, were also reviewed.

Updated 22 February 2020

About the service

Turnbull Close is a residential care home providing personal care to 10 people living with a learning disability and / or complex physical needs at the time of the inspection. The service can support up to 12 people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. Ten people were using the service at the time of the inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. The service is split into two joining units, each with six bedrooms, a bathroom, a kitchen and a lounge. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People were supported to be an active part of the local community, for example visiting day centres and cafes and they were supported with attending jobs and activities.

People were supported by enough staff who had been recruited safely and were trained and knowledgeable. The registered manager kept the staffing levels under constant review. This enabled them to make sure people were supported to attend appointments, work and other activities.

Risks to people’s health, safety and well-being were identified and measures were in place to minimise risks. Staff knew how to keep people safe and understood how to protect people from the risks of abuse, discrimination and harm. They knew how to report any concerns and felt they would be listened to. People were relaxed in the company of each other and staff. Staff knew people well and were observant in noticing small changes in people’s body language which may indicate they were unhappy, in pain or anxious. They knew what action to take to reduce people’s anxiety.

People were supported to have their medicines safely and on time. People’s physical, mental health, social and emotional needs were regularly reviewed, and they were referred to health care professionals when needed. Staff followed advice and guidance from health care professionals to help people stay as healthy as possible.

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.

People were supported by kind, caring and compassionate staff. Throughout the inspection we saw positive interactions and staff helped people to do things for themselves as much as possible. People were supported to stay in touch with people who were important to them and visitors were welcome at any time. Their privacy and dignity were respected. People lived together in a relaxed atmosphere. The service was clean and tidy, and people had decorated their rooms with their favourite possessions, such as photographs.

Regular checks on the quality of the service were completed and action was taken when a shortfall was identified. The registered manager welcomed feedback and had oversight of the service. They lead by example and staff told us they felt supported and valued by them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 16 January 2019 and this is the first inspection.

The last rating for this service was Good (published 15 August 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection based on our current inspection programme.

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.