We carried out a review of the data available to us about Trowbridge Oaks Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Trowbridge Oaks Care Home, you can give feedback on this service.
Trowbridge Oaks Care Home provides personal and nursing care for up to 52 people. Accommodation is provided over two floors accessed by a lift and stairs. People had their own rooms and there were communal rooms such as lounges, dining areas and a garden accessed from the ground floor. At the time of inspection there were 43 people living at the service.
People’s experience of using this service and what we found
At our last inspection we found that people who lacked capacity did not have consistent records in place to demonstrate decision making. At this inspection we observed this had improved. 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 living in a clean home that was well maintained. Windows were left open where possible and appropriate for additional ventilation. Chairs were spaced out to support social distancing and additional staff rooms had been created so staff could have their breaks safely.
People and staff were testing regularly for COVID-19 in line with government guidance. All visits to the home were pre-booked in advance and all visitors were screened. For example, staff checked visitors’ temperatures and asked screening questions about COVID-19 symptoms. Any visitor to the home also had to complete a Lateral Flow Test (LFT) prior to being able to go into the home.
Staff had been trained on safe infection prevention and control practice and we observed staff to be working in a safe way. Staff wore the correct personal protective equipment (PPE) and had specific areas in the home where they could put on fresh PPE when needed. The provider had plenty of PPE stock available.
The provider was carrying out monthly infection prevention and control audits to monitor safe systems of work. The regional director told us this was increased to weekly and daily if there was any concern or any positive cases of COVID-19. In addition, there were other quality monitoring systems in place to drive improvement and monitor quality and safety.
People had timely referrals to healthcare support they needed, and records were in place to monitor any action taken. Staff were supported by a range of healthcare professionals from the local community.
People told us they enjoyed the food on offer and had a choice of both food and drinks. Mealtimes were relaxed with staff providing support where needed in a person-centred way.
People’s risks were identified, assessed and recorded in their care plans with management plans in place. These were reviewed regularly by staff and updated when required. People’s needs were assessed prior to admission and staff used tools to continue assessments regularly. Staff attended handovers so they could keep up to date with people’s needs and any changes.
During our inspection we observed there were sufficient numbers of staff available although the service had experienced challenges with staff shortages. Action had been taken to try and obtain agency staff and the provider was looking at various ways to improve recruitment. Staff had been recruited safely.
People had their medicines as prescribed. Prior to our inspection we received information of concern about medicines management. We found staff had taken action to address shortfalls identified.
People were supported by staff who were trained and supported by the management and provider. Staff had access to resources to support their well-being. People and staff told us the service was well-led and the management were visible and approachable. There was a registered manager in post who made sure regulatory responsibilities were actioned.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 7 September 2019).
Why we inspected
We received concerns in relation to management of medicines and how people were being cared for. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.
We found no evidence during this inspection that people were at risk of harm from the concerns. Please see the safe, effective and well-led sections of this full report. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Trowbridge Oaks Care Home on our website at www.cqc.org.uk.
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.
Trowbridge Oaks is a residential care home providing personal and nursing care to 45 people at the time of the inspection. The service can support up to 52 people.
The home accommodated people across two floors and had been fully refurbished in 2019. There were communal spaces, including a lounge, dining room and garden.
People’s experience of using this service and what we found
Where people lacked capacity to consent to aspects of their care, the assessments in place needed improvements. Records about consent were inconsistent and needed to be reviewed.
There were some inconsistencies in people’s care plans where information was not updated as the person’s needs changed. Records about people’s day to day care did not consistently document the choices they were supported to make, or observations of their wellbeing. Instead, the records were often task focussed.
People had access to a range of activities taking place in the home. There were social events where community groups or people’s relatives could join in. Events were also based around celebrating people, their life history and successes.
People were supported by staff who knew them well. People and their relatives commented how friendly and kind the staff team were. People told us staff respected their privacy and cared for them with dignity.
People and their relatives told us they had a consistent staff team working at the home. The home was fully staffed and there were safe recruitment processes in place.
Staff received an induction, and ongoing training and supervision to meet the requirements of their role. Staff told us they felt they had received enough training and knew they could ask for more if needed.
Medicines were managed, stored and administered safely. There were weekly and monthly medicines audits.
People told us they felt safe. Staff understood their responsibility to identify and report any safeguarding concerns.
Staff felt supported by the registered manager. The registered manager promoted a culture of person-centred care and continuous learning.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 8 February 2017)
Why we inspected
This was a planned inspection based on the previous rating.
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.
This inspection took place on 10 January 2017 and was unannounced. We returned on 11 January 2017 to complete the inspection.
There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.
People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included, “I am very happy here. The staff are excellent”, “The staff are very kind. I love it here” and “The nurses and carers are always there when you need them”. A relative told us, “I am very happy with the care that has been provided”. We observed staff interacting with people in a friendly and respectful manner. Staff respected people’s choices and privacy and responded to requests for assistance.
People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Comments included “I feel very safe here. Moving in was the best decision I made” and “I feel safe living here”. Systems were in place to protect people from abuse and harm and staff knew their responsibilities to protect people and keep them safe from harm.
Staff understood the needs of the people they were providing care for. People told us staff provided care with kindness and compassion.
Staff were appropriately trained and skilled. They received a thorough induction when they started working at the home. They demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs.
The service was responsive to people’s needs and wishes. People had regular group and individual meetings to provide feedback about their care and there was an effective complaints procedure.
The provider regularly assessed and monitored the quality of care provided at Trowbridge Oaks. The information from these assessments and people’s feedback was used to make improvements to the service provided.
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. One relative said 'staff are extremely caring and supportive. I have no complaints, all basic needs are met'. One person living at the home said 'staff are cheerful, relaxed, and willing. They arrange for me to see the doctor or go to hospital'.
Staff received supervision, training, and professional development. One staff member said 'I feel well supported'.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.
The provider had an effective system to regularly assess and monitor the quality of service that people receive.
People presented as being well supported and their rights to privacy and dignity were maintained. Staff interacted with people in a caring and considerate manner.
A high number of people required staff assistance to eat and drink. Meals were served in a structured, organised manner. Staff were attentive to people's needs and gave people time without rushing. There was an emphasis on good nutrition to enhance people's wellbeing. People were supported to join in with various social activities which met their needs.
The environment was clean and systems were in place to minimise the risk of infection. Staff received infection control training and regular audits took place. Well maintained records demonstrated a comprehensive auditing system. People's care plans were detailed, up to date and reflected the individual's needs. Care charts and medication administration records were fully completed and well maintained. Records demonstrated a robust staff recruitment procedure was in place.
People looked well cared for with clean, laundered clothing, manicured nails and clean glasses. Those people in bed looked comfortable and relaxed. People were supported to have regular drinks and a choice of food which met their individual preferences. People in bed were supported to change their position at identified times to minimise their risk of developing a pressure sore. Attention was given to people's social needs and a range of group and individual activities were provided. People had their call bell within easy reach so they could call for staff assistance as required. They said staff generally came to them quite quickly when they called them.
People told us that they liked the staff. They said they were well trained and competent in their role. Staff told us they had very good opportunities to undertake training which helped them to do their job effectively. They felt well supported and were aware of their responsibilities to recognise and respond to an allegation or suspicion of abuse.
People told us that they felt safe within the home and were aware of how they could raise a concern. People said the manager was very approachable so they felt any issues would be quickly addressed and resolved. People said they were asked about their views of the service they received and were encouraged to give suggestions about how the home could be improved upon.