OSJCT Townsend House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed all the quality statements in the safe key question and found areas of good practice. The rating for this area has changed to good from requires improvement rating at the last inspection. Evidence showed people were safe. Staff had received training in safeguarding and knew how to report any safeguarding concerns. Risk assessments and management plans were in place and were reviewed regularly. Staff told us they had effective systems to guide them when supporting people during transitions. There were enough staff to support with these processes. There were systems and processes for staff to follow and incidents and accidents were analysed. Improvements were made in response to learning from incidents. There were enough staff to support people’s needs and the service was fully recruited. Medicines were managed safely. We were assured that the provider had effective systems and processes in place to prevent and control infections. They ensured infection outbreaks were effectively prevented or managed. We found some malodours in parts of the home. However, the provider took immediate action and addressed this. They also completed risk assessments and management plans which staff will use going forward.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they felt safe living at Townsend House. They could raise safety concerns and were confident they would be listened too. One person said, “If I wasn’t happy, I would tell one of the carers, definitely or I’d call the nurse.” One relative who had raised concerns before commented, “We found the manager in the office and the staff very acceptable to comments. They do seem to take note of family member views. We were happy with the outcome when we spoke to them.”

Staff and leaders told us there were effective systems in place which allowed safety events to be investigated and lessons learnt to continually identify and embed good practices. One member of staff said, “We have learning alerts after most incidents and more training if needed. We also have reflective meetings after any serious incidents.”

The provider had clear processes which allowed learning and a continuous process. This included learning from errors, accidents and incidents as well as near misses. Records showed staff championed reporting and recording of accidents and incidents.

People were supported to access other services by staff who knew their needs. There was a collaborative approach between people, relatives, the staff and other professionals to ensure continuity of care. People were positive they would be supported to access other services safely. One person said, “They [staff] say ‘you’re not feeling too good today, are you? Shall we get the doctor for you’. They would get the doctor, they would indeed.”

Staff told us they had effective systems to guide them when supporting people during transitions. Staff used personalised documents to capture people's needs and ensured this was shared with other professionals. There were enough staff to support with these processes.

Healthcare professionals who often worked with the service were positive about the processes in place which enabled people to access care and support when they needed it. One healthcare professional commented, “Staff work very well with other professionals such as the mental health team.”

The provider had streamlined processes which enabled continuity of care. There were referral processes which staff used effectively to seek healthcare specialist support. People's care plans were person centred and had all the information needed when accessing other services.

People told us they felt safe living at the service. They said, “Yes, it’s quite nice. I’ve been here quite a while and I just feel safe” and “Everything here makes me feel safe.” Relatives were equally positive about safety. One relative told us, “I do think Townsend House is safe for my mum. In all aspects of her care, from personal care to personal safety, and her medication, eating habits etc.”

Staff were trained in safeguarding. They were able to name different types of abuse and identify the common signs of abuse. Staff demonstrated that they knew who to report any potential safeguarding to and where to escalate this if necessary. One member of staff commented, “I will immediately notify the care leader on shift, head of care and manager within the home. Outside the organisation I will notify adult safeguarding team.” Staff told us people were supported in line with the principles of the Mental Capacity Act (MCA). Staff had received training about the MCA and understood how to support people in line with the principles of the Act. One staff member told us, “We try and support them to make their own decisions but if they can’t make their own decisions a power of attorney is put in place for them.”

We saw people engaged with staff in a relaxed manner and they looked comfortable in their presence. We saw the interactions were in a way which upheld people's human rights. There was a relaxed and calm atmosphere which enabled staff to focus on people’s individual needs.

The provider had a detailed safeguarding policy and procedure for staff to follow. This noted current information on what to do if anyone suspected a person was at risk of harm. Records showed that people were supported in line with the principles of MCA. Where people were thought to lack capacity, mental capacity assessments had been completed and best interest processes followed.

People told us they were supported to manage their risks by knowledgeable staff. There was a focus on positive risk taking which enabled people to do what was important to them.

Staff told us risks to people’s well-being were being managed well. Staff followed risk assessment and management plans which were person centred and gave them enough guidance to support people effectively. Staff sought and followed professional support. Staff met with healthcare professionals on a regular basis to share best practice, review people’s presenting risks and take action to ensure people were cared for appropriately.

We saw people had risk assessments and management plans which included areas such as falls, skin integrity and choking. We saw staff following them. Where people had been assessed as requiring regular checks, records seen indicated that these had been completed and we saw staff completing them at the point of care. We saw staff encouraged people to complete tasks that they still could whilst they were at hand to support when needed.

The provider had effective policies and procedures which guided staff during care and support. The provider had good oversight in the recording and monitoring of the risks people faced in their lives. This included monitoring falls and pressure ulcer risks. Staff considered patterns and trends in order to minimise the risks to people and inform staff how to support people safely.

People were positive about the environment. They told us they had access to a number of communal sitting areas around the home including a conservatory where people could spend their time. They had personalised rooms decorated with personal effects. The home allowed free access and people could move around freely in the communal areas of the building and the outside space which had beautiful, maintained gardens with several sitting areas.

Staff told us whilst some new furniture had been introduced, the actual internal building needed updating. The registered manager had identified this and were consulting with the provider so as to agree on appropriate changes.

We found the environment was not dementia friendly and made it difficult for people living with dementia to navigate through. The registered manager told us they had already identified this and were working through an action plan to improve the environment.

The provider had systems in place to ensure safety of premises. Fire and legionella risk assessments were often completed in line with national guidelines. There were systems to ensure equipment was kept in service and maintained in line with manufacturer’s guidelines.

People told us there were enough staff to meet their needs and they did not have to wait for support. They said, “There could be more but it’s not bad. They have time if need be. Sometimes they are quick to respond, it depends on what they are doing” and “There is always someone around and I never wait long when I call for help.”

Staff told us that there was enough staff to meet people’s needs and that planned staffing levels were met. Staff confirmed they worked well as a team and the skill mix complemented this. Comments included, “I work nights and we have 3 staff on shift it’s doable but if we have any emergency, we call on call to give us support” and “Yes we have enough staff to meet our residents’ needs in aspect giving personal care and assisting with meals as well as engaging them in social activities.” New staff completed a comprehensive induction and did not work unsupervised until they and their line manager were confident, they could do so. The induction included the provider’s own mandatory training as well shadowing opportunities of experienced members of staff. The registered manager told us staff supervisions and appraisals were behind but had now been scheduled. However, staff told us they felt supported, and records showed they had comprehensive competency checks completed.

On the first day of the assessment, we saw staff worked short and looked continuously busy. This had been due to very short notice absence which could not be covered. On the second day, the team were fully staffed and did not look rushed. Where people required support, we saw staff were available and responding to call bells in a reasonable time. Staff told us that had been a one off as they often work fully staffed.

Records of staff rotas showed planned staffing levels were met. The registered manager told us they were fully recruited and only used agency staff to cover short notice absences. Records showed the provider followed safe staff recruitment processes which included disclosure and barring service checks (DBS). The provider had quality assurance systems in place which ensured safe staffing levels.

People were positive of the cleanliness of the home. They told us staff wore personal protective equipment (PPE) and were always cleaning. People’s equipment was clean and had been serviced.

Staff told us they received training in infection prevention and control (IPC) and often had their practice checked. The provider had a policy which staff followed. Staff practices in IPC were often checked to reduce chances of complacency.

We found there were malodours in some parts of the home. The provider took immediate action to address this. They also completed risk assessments and management plans which staff would use going forward. We saw staff had access to PPE and were using it correctly. Staff told us infection control was everyone’s business and as such they challenged each other’s practices. Records showed staff practices were often checked.

Whilst the provider's audit system had identified malodours in the home, this had not been resolved. However, the provider had systems and processes in place to prevent and control infections. They ensured infection outbreaks were effectively prevented or managed. The provider had an up-to-date infection control policy which staff followed. Infection prevention and control was quality assured through the provider's processes.

People told us they received their medicines as prescribed and were involved in planning including when change occurred. People’s medicines were reviewed yearly and as and when necessary. Comments included, “They help me take them [medicines] if need be” and “They help me with my creams, those over there.”

Staff met good practice standards described in relevant national guidance, including in relation to non-prescribed medicines. Staff had been trained in administering medicines and had their competencies to administer medicines regularly checked. One member of staff told us, “Medicines competency checks are done once a year but if there are any more medication errors made, one can have an ad hoc check.”

The provider had a medicine policy in place which guided staff on how to administer and manage medicines safely. Records showed people’s medicines were often reviewed. There were processes in place to ensure compliancy. The management team completed monthly medicines management audits with outcomes used to improve people’s care.