CQC report explained · a residential care home
What the CQC found at Towneley House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed and reviewed, staff recruitment included criminal record checks, and infection prevention arrangements were judged suitable. Inspectors did identify minor recording problems with some 'as and when needed' medicines.
- Effective?
- Good
- People received personalised care, suitable food and drink support, staff training and timely access to health professionals. Inspectors recommended better recording of evidence about powers of attorney.
- Caring?
- Good
- This key question was not inspected during this visit, so no rating was given in this report.
- Responsive?
- Requires improvement
- This key question was not inspected during this visit, so no rating was given in this report.
- Well-led?
- Good
- The manager used audits, meetings and feedback to improve the home. Staff said they felt supported, and professionals said communication with the home was good.
What inspectors found, September 2022
Towneley House was rated Good; inspectors found safe, kind and well-managed care, but identified gaps in some medicines and legal records.
The unannounced inspection took place on 20 July 2022. One inspector and an Expert by Experience spoke with people living in the home, relatives, staff and health and social care professionals. They also reviewed care plans, medicines records, staff files and other records.
The home was rated Good overall. Safe, Effective and Well-led were also rated Good. Inspectors found that people felt safe, staff were trained and supported, risks were assessed, care plans were personalised and the manager responded to feedback.
There were two recommendations. The home was asked to improve how it monitors medicines taken 'as and when needed' and how it records evidence of powers of attorney. These were recording and practice issues, although inspectors said medicines were being given appropriately.
The previous rating was Requires Improvement, published in October 2020. Inspectors found enough improvement for the overall rating to become Good, and the home was no longer in breach of Regulation 15 about premises and equipment.
People felt safe
People and relatives told inspectors they felt safe. Staff understood safeguarding and knew how to report concerns.
“People we spoke with felt safe living in the home. Relatives also said they felt their loved ones were safe.” from the report
Personalised care
Care plans described people's individual needs, wishes and choices. Staff supported people to make decisions wherever possible.
“Assessments were unique to the individual and contained information and guidance specific to each person’s needs and wishes.” from the report
Supported staff
Staff received induction, training and regular support. The manager arranged extra training for people with specialist needs.
“Staff received an appropriate level of support for their role through regular appraisal.” from the report
Responsive management
The manager acted on inspection feedback and used audits and meetings to identify improvements.
“The registered manager was responsive to feedback given throughout the inspection and immediately acted on the findings.” from the report
Positive relationships
Inspectors saw that people were comfortable with staff and that positive relationships had developed.
“We saw that people were comfortable in the presence of staff and positive relationships had developed between people receiving support and staff.” from the report
As-needed medicines records
needs fixingSome medicines prescribed to be taken when needed were not monitored effectively. Inspectors said people were receiving their prescribed medicines appropriately, but recommended that the home update its practice.
“some medicines that were to be taken 'as and when needed' were not being monitored effectively.” from the report
Power of attorney records
needs fixingCare plans said when relatives had legal authority to make decisions, but the supporting evidence could not be found in the care files. The home was asked to improve its records.
“we were unable to see the evidence of this in the care files.” from the report
One area needing decoration
minorThe home had an improvement plan, but inspectors saw one area that still needed decorating. The manager said this work was in progress.
“We observed one area in need of decoration however the registered manager assured us that this was in the process of being improved.” from the report
- 01How do you now record and monitor medicines prescribed to be taken 'as and when needed'?
- 02How do you check that evidence of powers of attorney is recorded in each relevant person's care file?
- 03What work has been completed on the area that inspectors said needed decoration?
- 04Which ratings from the previous inspection were carried forward rather than assessed during this visit?
- 05How do you use audits and feedback to make sure the improvements identified by inspectors remain in place?
This was a focused inspection that assessed Safe, Effective and Well-led; Caring and Responsive were not inspected during this visit, and the report says ratings for uninspected key questions were carried over from the previous inspection. This explanation was written from the published report of 14 September 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2020
Rated Requires Improvement; inspectors found better infection control and management, but some safety checks and records still needed work.
This was an announced, focused inspection on 29 September 2020. The inspector checked Safe and Well-led, including infection control during the COVID-19 pandemic. The report also used earlier ratings for the other areas.
The home had improved since the previous inspection. Inspectors found enough improvement in infection control and governance for the earlier breaches in Regulations 15 and 17 to end. Staff were available, people were protected from abuse, medicines were generally managed safely, and care records reflected people's choices.
Some important work was still unfinished. Fire appliance and gas safety checks were overdue at the visit. Risk assessments and the review of accidents and incidents needed more detail. The overall rating stayed Requires Improvement, and the home had received this rating for five consecutive inspections.
Protection from abuse
Staff knew how to raise safeguarding concerns, and people and relatives said they felt safe. Staff were confident that managers would act quickly if they reported a concern.
“Staff were confident the registered manager would act quickly to keep people safe if they reported any concerns.” from the report
Staff availability
Inspectors found enough staff to respond promptly to people's needs. People said they did not have to wait for help.
“We observed staff were attentive and responsive to people's needs.” from the report
Improved infection control
The home was cleaner and infection control arrangements were judged sufficient at the inspection. The earlier breach relating to premises and equipment had ended.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 15.” from the report
Person-centred care
Care records reflected people's choices and preferences. People and relatives were involved in decisions where appropriate.
“Care was planned in a person-centred way which helped ensure good outcomes for people.” from the report
Overdue safety checks
seriousFire appliance and gas safety checks were overdue during the inspection. The manager said they had been delayed during the pandemic and were arranged for that month.
“However, the fire appliance checks, and the gas safety checks were overdue.” from the report
Risk assessments lacked detail
needs fixingEnvironmental risk assessments did not fully describe some risks, including stairs, chair lifts and bedroom door keys.
“We discussed how they needed to be more detailed, particularly in areas such as the use of stairs, chair lifts and availability of bedroom door keys.” from the report
Medicine records
minorThere were gaps in records for applying creams. Boxed and bottled medicines showed arrival dates instead of opening dates, although the manager later said this had been addressed.
“We found some gaps in the records relating to the application of creams.” from the report
Staff meetings not documented
minorStaff meetings took place, but there was no written record of them. Inspectors suggested bringing back regular formal meetings.
“Staff meetings were taking place but were not documented.” from the report
- 01Have the overdue fire appliance and gas safety checks now been completed, and can you show us the certificates?
- 02How have you made the environmental risk assessments more detailed, especially for stairs, chair lifts and bedroom door keys?
- 03How do you now analyse accidents and incidents to identify repeated risks or patterns?
- 04How are you checking that cream application records and medicine opening dates are complete?
- 05What was the breach in the key question not covered by this inspection, and what action has been taken since?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 17 October 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Towneley House
7 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- September 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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