Town Close

Updated 2 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 26 September 2017 and was announced. The provider was given notice because the location provides support in an extra care scheme and we needed to be sure someone would be available in the office to answer our questions. Calls to people who used the service took place on 22 September 2017.

The inspection was conducted by one adult social care 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. Their area of expertise was older people and dementia.

The provider completed a provider information return (PIR) and returned this within required timescales. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan this inspection.

We reviewed other information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales. We also sought feedback from the Local Authority.

During the inspection, we reviewed a range of records. These included three people's care records containing care planning documentation and daily records. We also looked at one staff file relating to their recruitment, and four staff files relating to supervision, appraisal and training. We viewed records relating to the management of the service and a wide variety of policies and procedures.

During the inspection, we spoke with five members of staff including the service manager and team leader. Prior to the inspection, we contacted six people who used the service by telephone to seek their views.

Updated 2 November 2017

This inspection took place on 26 September 2017 and was announced. The provider was given notice because the location provides support in an extra care scheme and we needed to be sure someone would be available in the office to answer our questions. Calls to people who used the service took place on 22 September 2017.

Town Close registered with the Care Quality Commission (CQC) in December 2012 for the regulated activity of personal care. The service is based in Stokesley and is an extra care housing scheme. They offer personal care and support to people who live in apartments on-site. At the time of this inspection there were 21 people who were receiving support with personal care.

At the last inspection in July 2015, we rated the service as Good overall, but identified that improvements were required in the safe domain. We found medicines were not managed safely and a number of errors had occurred. Staff were not provided with sufficient information with regard to medicines and the possible side effects. At this inspection, we found improvements had been made; the number of medicine errors had reduced and a thorough audit system ensured action was taken when errors occurred.

The service did not have a registered manager. However, an application to register with CQC had been completed by the service manager and was being processed. 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.

The service manager and team leader were present throughout this inspection.

Safeguarding concerns had been managed appropriately. A safeguarding policy was in place to protect people from the risk of harm. All staff we spoke with were aware of the procedure to follow if they suspected abuse was taking place.

Recruitment procedures had been followed to ensure staff were safe to work and did not pose a potential risk to people who used the service.

Risk assessments were completed in relation to people’s individual needs. The risk assessments guided staff on what actions to take to minimise the risks to people, such as ensuring they had their lifeline pendent on, whilst also promoting their independence. Risk assessments had been updated when changes occurred to ensure they recorded people’s current needs.

People told us they trusted staff and felt safe in their care.

There was a process for completing and recording staff supervisions and competency assessments. Systems in place ensured staff received the training and experience they required to carry out their roles. A range of training was provided to ensure staff were able to effectively carry out their roles. New staff were given the opportunity to work alongside senior staff to build relationships with people.

Some people were supported by staff with meal preparation and where possible people’s independence was recorded and promoted in this area. Care records contained clear guidance for staff to follow with regard to nutrition.

Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005. Staff were aware of the procedure to follow if they suspected a person lacked capacity to make decisions.

Any concerns that staff had regarding people were recorded in daily notes. People told us that staff contacted relevant professionals such as GP’s, in a timely manner, when this was needed.

People told us they were treated with dignity and respect; they were supported by a regular team of staff who knew their likes, dislikes and preferences. Staff had built relationships with people based on their knowledge of people’s personal histories and medical conditions.

The provider had an effective system in place for responding to people’s concerns and complaints. All the people we spoke with were able to explain who they would contact if they had any concerns and were confident this would be dealt with effectively.

Staff were kept informed about the operation of the service through regular staff meetings and weekly newsletters. Staff we spoke with told us they felt well supported by the management and felt they had an open and honest approach. They were confident that any concerns raised would be dealt with in a professional manner.

The team leader completed a number of quality assurance checks to monitor and improve the standards of the service in areas such as medicines and daily visit reports. Action had been taken when concerns were found, although this was not always clearly recorded.

People were given the opportunity to provide feedback about the service and satisfaction surveys were distributed annually.

The service manager had a good understanding of their role and responsibilities .They understood when notifications were required to be submitted to CQC. Notifications are changes, events or incidents the registered provider is legally obliged to tell us about within the required timescales.

Further information is in the detailed findings below