Archived: Turn Furlong Specialist Care Centre

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.

At the last inspection, the service was rated Good; at this inspection we found that the service remained Good.

The 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. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A registered manager was in post at the time of the inspection, however they

were on a secondment and not available during the inspection. In the absence of the registered manager the deputy manager had taken on the role of manager supported by a deputy manager and the operations manager who visited the service during the inspection.

People received care from staff that were kind, compassionate and encouraged them to maintain their independence. Staff were respectful of people’s dignity and demonstrated an understanding of each person’s needs. This was evident in the way staff spoke to people and the activities they engaged in with individuals. People were treated as individuals and their privacy and dignity was protected.

Care plans detailed people’s needs, their likes and dislikes and preferences. The information gathered ensured that people were cared for safely. Staff understood their role and responsibility to keep people safe from harm.

There were sufficient staff to meet the needs of the people staying at the Centre; staffing levels were kept under review. There were appropriate recruitment processes in place which protected people from being cared for by unsuitable staff and people felt safe in the Centre.

Staff were supported through regular supervision and undertook training which helped them to understand the needs of the people they were supporting.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were involved in decisions about the way in which their care and support was provided.

People’s health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people’s care. Families and friends were welcome at any time.

There were effective quality assurance systems and audits in place; action was taken to address any shortfalls. Management was visible and open to feedback, actively looking at ways to improve the service.

We spoke with the nursing and care staff who were fully aware of the individual care and treatment needs of people using the service. We saw that people had their needs assessed and based upon the assessments a care plan was put in place to instruct the staff on how people were to be supported. However we found some discrepancies in record keeping. For example, we found assessment forms were not always fully completed and the care plans for people on respite care did not always clearly identify each time a person had been admitted and discharged or whether people's needs were re assessed upon each admission.

Throughout Turn Furlong Specialist Centre we observed that staff conducted themselves professionally, we heard them speak respectfully to people, respect peoples privacy and they worked at a relaxed pace giving people time to make decisions.