We carried out a review of the data available to us about Turfcote Care Home with Nursing 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 Turfcote Care Home with Nursing, you can give feedback on this service.
We found the following examples of good practice.
The provider had a recruitment drive in place to ensure there were enough staff at the service to meet people’s needs. Gaps in staffing were filled by agency staff.
Guidance had been implemented to allow people to receive visitors safely and where visits had been restricted people were supported to maintain contact by telephone.
A regular testing programme for COVID-19 for staff and people living at the home was in place, and where positive results had been returned action was undertaken to mitigate risks.
Some staff did not wear PPE correctly. This was addressed at the visit and the provider confirmed the correct use of PPE had been reinforced to staff. Designated areas for donning and doffing PPE were not clear and this was discussed at the visit.
People were encouraged to social distance. Lounges and dining rooms had been set out with space between people. Staff movement within the home had been adapted to reduce footfall between the general care and the dementia care units to help minimise the potential transmission of infection.
At our inspection on 27 June 2017 we found breaches of legal requirements. There were concerns about the unavailability of suitable activities for people in the home, records in care plans were incomplete with poor recording of support and care reviews and the service’s checks and audits were not picking up on issues.
We asked the provider to make improvements in all of these areas and they kept CQC informed of the changes that had been made.
At this inspection we found that improvements had been made in all of these areas but that further steps were required in relation to the provision of activities for people.
We found that there were activities available for people and that the home had employed an activities coordinator. However, there were days when sufficient activities were not arranged and the activities coordinator required training. Records in care plans were complete and accurate and the service’s auditing systems were highlighting issues of potential concern and checks were being made to ensure that the service operated effectively.
Turfcote Care Home with Nursing is a ‘care home’ in Rossendale in the county of Lancashire. 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 home is registered to provide accommodation and support for up to 76 people and cares for people, including those living with dementia and general nursing and personal care. At the time of our inspection 46 people were using the service.
There was a registered manager in place who had been registered since 1 October 2010. 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.
People using the service said they felt safe and that staff treated them well. There were enough staff on duty and deployed throughout the home to meet people’s care and support needs. Safeguarding adult’s procedures were robust and staff understood how to safeguard people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work.
People were supported to maintain a balanced diet and had access to a range of healthcare professionals when required. People received appropriate end of life care and support.
We found that people and their relatives, where appropriate, had been involved in planning for their care needs. Care plans and risk assessments provided clear information and guidance for staff on how to support people using the service with their needs. People and their relatives knew about the home’s complaint’s procedure and said they were confident their complaints would be fully investigated and action taken if necessary.
The registered manager and provider conducted regular checks to make sure people were receiving appropriate care and support. The registered manager took into account the views of people using the service, their relatives and staff through meetings and surveys. The results were analysed by the provider and action was taken to make improvements at the home. Staff said they enjoyed working at the home and received appropriate training and good support from the management team.
There were also issues with the recording of and responses to minor concerns raised by people and their relatives. There were concerns around a failure to ensure that people were offered a range of suitable activities and it was noted that mealtimes were not used as an opportunity for people to interact with a subdued atmosphere. We recommended that the service looked at ways of improving these areas of concern so that people were effectively supported.
We asked the provider to make improvements in all of these areas and they kept CQC informed of the changes that had been made.
At this inspection we found that improvements had been made in some of these areas. We found that people were not left waiting for assistance and minor concerns were being recorded and responded to appropriately. Mealtimes were a positive experience with staff interacting with people and the atmosphere was light with staff encouraging people and offering choices.
However, at this inspection we still had concerns about the unavailability of suitable activities for people and that the service’s checks and audits were still not picking up on issues. This has resulted in breaches of legal requirements.
We also established that records in care plans were incomplete and there was poor recording of support and care reviews. This has resulted in a breach of legal requirements.
You can see what action we told the provider to take at the back of the full version of the report
Turfcote Care Home with Nursing is a nursing home in Rossendale in the county of Lancashire. The home is registered to provide accommodation and support for up to 76 people and cares for people, including those living with dementia and general nursing and personal care. At the time of our inspection 56 people were using the service.
There was a registered manager in place who had been registered since 1 October 2010. 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.
People using the service said they felt safe and that staff treated them well. There were enough staff on duty and deployed throughout the home to meet people’s care and support needs. Safeguarding adult’s procedures were robust and staff understood how to safeguard people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work.
We found that people and their relatives, where appropriate, had been involved in planning for their care needs. Care plans and risk assessments provided information and guidance for staff on how to support people using the service with their needs. People and their relatives knew about the home’s complaint’s procedure and said they were confident their complaints would be fully investigated and action taken if necessary.
The provider took into account the views of people using the service, their relatives and staff through meetings and surveys. The results were analysed and action was taken to make improvements at the home. Staff said they enjoyed working at the home and received appropriate training and good support from the registered manager.
Turfcote Care Home with Nursing provides accommodation for 76 people who need either nursing or personal care and support. There are two units. Tor View provides general nursing care for up to 46 people and Grane View provides care for up to 30 people who are living with a dementia or have mental ill health. A reablement unit was available for people who had been discharged from hospital but needed further treatment before going home. At the time of the inspection there were 57 people accommodated in the home.
The service was managed by 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.
During this inspection visit we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to the deployment and availability of staff and ineffective quality assurance systems. You can see what action we told the registered provider to take at the back of the full version of the report. We also made recommendations about the provision of suitable activities, improving mealtimes and the recording of people's concerns.
People made positive comments about the management of the home. We found there were systems to monitor and improve the quality of the service and to obtain people’s views of the service although they were not always effective.
People told us staff were kind and caring. Staff were able to describe the action they would take if they witnessed or suspected any abusive or neglectful practice. The registered manager and staff understood their responsibilities in promoting people's choice and decision-making under the Mental Capacity Act (MCA) 2005. Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected. However, people’s consent to care had not been recorded.
People’s medicines were managed safely by staff who were appropriately trained to do so. People told us they were given their medicines when they needed them.
People were cared for by staff that had been recruited safely. Appropriate checks had been carried out to make sure staff employed were of good character.
People had mixed views about staffing numbers and the availability of staff. People told us there were not enough staff and they had to wait for assistance at times. Staff told us there were sufficient staff but there were problems with the way some staff worked. The staffing rotas showed there were sufficient numbers of staff to support people although feedback indicated that the deployment, direction and daily supervision of staff was an issue and needed to be reviewed to ensure people’s needs were met at all times.
Staff received training and support to meet the needs of people using the service. People felt staff had the skills and knowledge to provide them with effective care and support.
During our visit we observed people being sensitively supported, encouraged and reassured. However we also noted at times staff only interacting with people during tasks. We did not observe staff sitting and chatting with people. From our observations and discussions we found that the management team and staff were knowledgeable about people’s individual needs, preferences and personalities.
We found the home to be light, clean and airy. People raised no issues about the cleanliness of the home. We noted a number of improvements had been made since our last inspection visit although we found some areas were in need of attention. The management team were able to describe the planned and needed improvements and people confirmed there had been improvements made. Regular health and safety checks were carried out. People told us they were happy with their bedrooms and some had created a homely environment with personal effects.
The service liaised with other health and social care professionals to make sure people received co-ordinated and effective care and support.
People told us they enjoyed the meals and were given a choice. The menus offered meal choices although we noted choices were not offered on the dementia unit. We found drinks and snacks were regularly offered. We noted the dining experience could be improved as the atmosphere was subdued in all dining areas with little interaction from staff throughout the meals.
Everyone had a care plan, which had been reviewed and updated on a monthly basis. Information was included regarding people’s likes, dislikes and preferences, routines, how people communicated and risks to their well-being. People told us they were kept up to date and involved in decisions about care and support.
We found there were limited opportunities for people to engage in suitable activities both inside and outside the home. The home did not have an activities co coordinator and was reliant on staff availability. People and staff told us there was not a lot going on.
People told us they would raise any issue of concern. There was a complaints procedure and records had been maintained of people’s complaints. However, people's 'minor' concerns were not always clearly recorded which meant it was difficult to determine whether there were recurring problems and whether appropriate action had been taken.
During this inspection we looked at three people's care records, observed staff practice and spoke with three staff. We found the information in people's care plans had improved.
People's preferences, routines and needs were clearly recorded which should help to support that people's choices were respected and should prevent any 'institutional' type practice.
Staff had recorded the level of support people needed with everyday tasks and the reasons behind taking 'best interest' decisions for people. This should help keep people safe.
Records reflected any equipment in use and the care and support needed to reduce any identified risks.
There were records of people's meal choices. This should help to determine whether people's nutritional needs were being met, particularly on Grane View.
A detailed care plan 'audit' tool had been introduced since our last inspection. Care plans were regularly checked by a senior member of staff who identified any shortfalls for staff to action. Staff told us the system was effective and improvements had been made to the way people's needs, care and support was recorded.
We conducted an early morning visit as we had received information from a whistle blower. The concerns were shared with the local authority and reviewed as part of this inspection.
We found people's care and treatment was delivered in line with their individual needs. However, the records did not always reflect people's choices or reasons for decisions around care and support. People said there were opportunities for involvement in daily activities but generally this was when staff were available.
People were encouraged to discuss any concerns. One person said, "I'm always asked if I am okay; I am given lots of opportunities to discuss any concerns I might have".
People's nutritional needs had been assessed which helped determine whether they were at risk of dehydration or malnutrition. People told us they were provided with a choice of nutritious food and drink. Comments included, "The food is lovely; it's like being in a hotel" and "We get plenty to drink through the day and something at supper time".
People told us there were enough staff to meet their needs and said, "Staff are lovely; they work very hard" and 'Staff are very good; they often bob in for a quick chat or just to check I am alright'. We spoke with five staff who told us they had the training and support they needed.
provider to send us an action plan to indicate how and when they would achieve compliance with the regulations. During this visit we reviewed our previous concerns and found the provider had taken reasonable action to improve the service.
During our inspection visit we spoke with four people who used the service. Some people were unable to express their views so we also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us to understand the experience of people who could not talk with us.
All the people we spoke with told us they were happy with the care and support they received. Comments included, "I like it here; they look after me" and "They talk to me about my care and about what I want". People were provided with appropriate activities and entertainments. One person said, "There is plenty going on but sometimes I prefer to do my own thing. There is never any pressure to get involved if you don't want to".
People who we spoke with told us they were treated well and had no concerns about the service or with individual care staff. Comments included, "I feel safe and looked after", "They are very kind" and "They always ask me if I am alright".
People told us there were sufficient staff to meet their needs. People made positive comments about the staff team. They said, "The staff are lovely" and "They are kind and patient with me". We observed staff interacting with people in a pleasant and friendly manner and being respectful of people's choices and opinions.
People told us they were able to express their views and opinions and could influence
the way the service was run. They told us they did not have any complaints about the service.
People told us they were given choices about how to spend their day. Comments included, "I can choose what I want to do", "I can do what I want" and "It's not home but it is the next best thing".
All the people that we spoke with told us they were happy with the care and support they received and said "I am well looked after", "I can see my doctor if I am not feeling well", "I am satisfied" and "I am happy". They told us they were looked after properly and that staff treated them well. Comments included, "Staff are very kind", "Staff are nice to me" and "I can talk to the staff if something is wrong, they would sort it out".
People told us they were confident to speak up if they had concerns and that the manager, owner and staff often asked if they were "comfortable" and "happy".
Staff told us they were part of a good team and that management was "very supportive" and "approachable". They told us they were given the ongoing support and training that they needed.