Archived: Carewatch (Turnberry Court)

Carewatch (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 2 two-bedroom flats within one building. There were 36 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.

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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

People who used the service were supported by caring staff to exercise their choices and remain as independent as possible. The staff worked in a person-centred way and knew people’s individual needs and how to meet these. The staff were supported by the management team to work together for the benefit of people. People’s relatives told us they were happy and had meaningful and fulfilling lives. 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 to pursue their interests and achieve aspirations and goals. People took part in social activities of their choice.

Staff enabled people to access specialist health and social care support in the community. People received their medicines safely and as prescribed.

Right Care

The staff were kind and caring. Staff protected and respected people’s privacy and dignity. People’s needs were met by staff who were well trained and supported.

Staff received training in safeguarding adults and understood how to protect people from poor care and abuse. People were supported to maintain their skills and interests. People’s communication needs were understood and met.

Right Culture

Most relatives and staff told us the culture of the service was good, and felt people received good quality care and support. Written comments from people showed they were happy with the service and the care workers who supported them. The management team had worked hard to make improvements since the last inspection and this had created an improvement to people’s quality of life. Overall, the staff demonstrated a trust in the management team and told us they were happy, enjoyed their work and felt appreciated.

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 23 April 2022) and there were breaches 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 carried out an unannounced inspection of this service on 15 and 17 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and well-led.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Carewatch (Turnberry Court) on our website at www.cqc.org.uk.

Follow up

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

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 41 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

Staff did not always follow the procedure for recording and the safe administration of medicines and we could not be assured people received their medicines safely and as prescribed.

There were systems for monitoring the quality of the service, gathering feedback from others and making continuous improvements. However, systems were not always effective and had failed to identify the shortfalls we found during the inspection. Where concerns had been identified, these had not always been investigated or addressed in a timely manner. The provider was responsive to our feedback and took prompt action to make the necessary improvements.

People’s needs were assessed before they started using the service and care and support plans were developed from initial assessments. However, some people’s needs had increased and healthcare professionals expressed concerns their needs may not be met in the near future. The management team told us they were liaising with the local authority to get people’s needs reviewed.

Feedback from people who used the service and their relatives was mostly positive. People felt their needs were met by kind and caring staff who respected them.

Risks to people’s safety and wellbeing were assessed and appropriately mitigated.

People were supported to remain as independent as they could and were encouraged to mix with others in the communal areas. The housing department was responsible for providing activities to people who used the service although the provider was also planning on organising a range of activities to improve people’s social lives. Most people felt consulted in all aspects of their care and support and felt listened to.

Staff felt happy working for the service and were supported by their managers. 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 the service under the previous provider was requires improvement, (published on 1 December 2020).

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

The inspection was prompted in part due to concerns received in relation to the care of people who used the service, and the registered manager leaving the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Turnberry Court 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. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.