Tozer House

Updated 11 October 2022

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 Health and Social Care Act 2008.

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.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience. 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

Tozer House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Tozer House 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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 reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We communicated with seven people who used the service and four relatives about their experience of the care provided. The Expert by Experience contacted relatives remotely by telephone. People who were unable to speak with us used different ways of communicating. Some people used Makaton and communicated through staff, others used pictures, their body language and facial expressions.

We spoke with eight members of staff including the registered manager, area manager, quality assurance manager, senior support workers, support workers and outreach staff. We reviewed a range of records. This included five people's care records and three medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality assurance information and maintenance records were reviewed.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found. We looked at staff rotas, training data, and the providers policies and procedures.

Updated 11 October 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Tozer House is a residential care home providing accommodation and personal care for up to 15 people living with a learning disability, physical disabilities and autistic people. Care is provided across two houses, one of which can accommodate seven people and the other which can accommodate eight. There were two separate buildings used for activities, offices, kitchen and dining area. At the time of the inspection 10 people were living at the service. Five people were living in each house.

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

Right Support:

People were supported to have the maximum possible choice, independence and control over their lives. People were supported to stay safe in a way which promoted their independence and met their needs and preferences. People and those important to them were involved in their care and support was planned to ensure people had a good quality of life. A relative told us, “All [person’s] needs are being met and it’s a nice atmosphere there. It’s all about the place.” Staff supported people to make decisions and go to places of their choosing. People were supported to maintain relationships with those who were important to them, they could visit people outside their home and have people visit them. People were supported in a safe, clean environment which was suited to their needs. 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.

Right Care:

People received kind and compassionate care. Staff respected and promoted people's dignity, privacy and human rights. Care and support plans were person-centred, identified people's strengths and promoted independence. Staff were appropriately skilled to meet people's needs and keep them safe. One person told us, “Staff are always here to give you a bit of help when you need it.” Staff understood how to protect people from poor care and abuse and worked well with other agencies to do so. People told us they felt safe and had good relationships with staff. People had unrestricted access to their rooms which promoted privacy and dignity. Staff ensured people's human rights were met and people were supported to understand they have the same rights and responsibilities as everyone else.

Right Culture:

The managers and staff demonstrated values, attitudes and behaviours which enabled people to lead confident, inclusive and empowered lives. Staff placed people's wishes, needs and rights at the heart of everything they did. Staff had a proactive approach to dealing with issues and concerns to enhance people’s wellbeing and reduce potential risks to their health and safety. The service promoted a homely culture and people were cared for in this way. Staff had received specific training to meet the needs of people with a learning disability and autistic people and spoke with passion about people and the care and support they provided. The service promoted an open and transparent culture which encouraged people and those important to them to share their views and ideas for developing the service. We saw staff fully involving people with tasks and activities they had chosen; and interactions between people and staff were patient, kind, sensitive and assuring.

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 08 January 2020) and there were two 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 comprehensive inspection of this service on 05 November 2019 and 11 November 2019. Two 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 good governance. 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.

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.

Follow up

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