Background to this inspection
Updated
2 November 2019
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 two inspectors, an assistant 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.
Turn Furlong Specialist Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the Care Quality Commission although a temporary manager was in post at the time of inspection. This means that only the provider was legally responsible for how the service was run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with 14 people who used the service and five relatives about their experience of the care provided. We spoke with nine members of staff including the manager, nurses, care workers and kitchen staff. We spoke with four professionals who regularly visit the service.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
2 November 2019
About the service
Turn Furlong is a respite and rehabilitation service providing personal and nursing care to 39 people aged 65 and over at the time of the inspection. The service can support up to 51 people across separate wings, each of which has separate adapted facilities. One of the wings specialises in providing care to people living with dementia.
People’s experience of using this service and what we found
Doors within the service were not kept secure. This meant people were able to access areas where they were exposed to the risk of harm. Storage of clean and used equipment and people’s belongings was disorganised. This meant people were not protected from the risk of infection.
There were not enough staff to meet people’s needs. The provider used a large proportion of agency staff who were not familiar with the service and did not receive sufficient support from permanent staff to carry out their role safely. People did not receive their medicines on time.
There were some systems in place to monitor the quality of the service however these were not effective in identifying areas for improvement. The provider had not identified the issues we found during inspection. When there were problems, the manager did not always deal with them appropriately or work to reduce the likelihood of recurrence.
Care records did not always contain details of all aspects of people's care and support needs. Risk assessments were not always completed as soon as people arrived at the service and were not always updated as people’s needs changed.
People and their relatives were not involved in the planning and delivery of their care, and feedback was not regularly asked for or acted upon. Staff were not encouraged to be actively involved in service development.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Staff worked in partnership with the local authority and health and social care professionals.
Appropriate recruitment checks took place before staff started work. Staff received sufficient training to enable them to carry out their roles effectively. People and relatives spoke positively about care staff.
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 22 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to the safety of the environment and infection control, staffing and governance.
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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.