We inspected the home on the 2 December 2014 and the visit was unannounced. Our last inspection took place on 14 October 2013 and at that time we found the service was meeting the regulations.
During the visit, we spoke with 12 people living at the home, a relative, six members of staff, the registered manager and the care manager. We also spoke with a district nurse who was in the service giving treatment to people via the local doctor’s surgery.
The home had a registered manager, who had been registered at Townend Close since 2006. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the registered provider.
Townend Close is registered to provide personal care and accommodation for up to 39 adults and has a designated respite room which is regularly used by people who need a short stay. Some people using the respite facility use it as a ‘phased’ introduction to the service. Townend Close is owned and managed by Anchor Trust. The purpose built detached property is close to local amenities, and the towns of Skipton and Keighley. The home's accommodation is arranged over two floors. All the rooms have a bedroom/living area, a kitchenette and bathroom. Each room has an individual front door with letterbox, which leads off a communal corridor. There is a passenger lift available to reach the first floor and parking for visitors. On the day of the inspection 29 people were living in the home, all were permanent residents.
Some people living in the home had complex needs and had difficulties with verbal communication. The staff had developed different communication methods in accordance with people’s needs and preferences. This approach reduced people’s levels of anxiety and stress.
People told us they felt safe in the home and we saw there were systems and processes in place to protect people from the risk of harm.
The registered provider had policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. The registered manager had been trained to understand when an application should be made, and in how to submit one. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.
We found people were cared for, or supported by, sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show that staff employed were safe to work with vulnerable people.
Suitable arrangements were in place to provide people with a choice of a varied diet with healthy food and drink ensuring their nutritional needs were met.
People’s physical health was monitored. This included the monitoring of people’s health conditions and symptoms, so that appropriate referrals to health professionals were made.
People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The care plans contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. Care and support was tailored to meet people’s individual needs and we could tell that staff knew people well. The support plans included detailed risk assessments. Staff had good relationships with the people living at the home and the atmosphere was relaxed and had a homely feel to it.
Medicines were administered, stored and disposed of safely and people using the service received their medication as prescribed.
We observed interactions between staff and people living in the home and staff were kind and respectful to people when they were supporting and assisting them. Staff knew how to respect people’s privacy and dignity. People were supported to attend meetings, where they could express their views about the home. Relatives also attended meetings to make sure they had a ‘voice’ in the running of the service.
A range of activities were provided both in-house and in the community. People were able to choose where they spent their time. For example, in the communal lounge, small seating areas throughout the building or in their own rooms. We saw people were involved and consulted about all aspects of the service including what improvements they would like to see and suggestions for activities. Staff told us people were encouraged to maintain contact with friends and family.
The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. People we spoke with did not raise any complaints or concerns about living at the home.
There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the registered manager and the registered provider. Staff told us they were always looking at ways to improve the home, the service they provide and the quality of people’s care. This meant people were benefiting from a service that was continually looking how it could provide better care for people. Staff told us they were supported to challenge and make suggestions, through their staff meetings and with discussions at handover, when they felt there could be improvements. There was an open and honest culture in the home.