CQC report explained · a nursing home
What the CQC found at Turner Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2021
Turner Home rated Requires Improvement; inspectors found safer medicines and care, but records and quality checks still needed work.
This was an unannounced focused inspection on 19 and 20 May 2021. Inspectors checked Safe and Well-led, spoke with people, relatives and staff, observed care and reviewed records.
The home had improved since the previous inspection. Medicines were managed safely, risks had personalised assessments, staffing levels met people's needs and the home was clean and well maintained.
Some important work was still unfinished. Health and care records were not always completed as planned, and quality checks did not always make clear who should complete actions or when they were due.
The overall rating remained Requires Improvement. The home was no longer in breach of the regulations identified at the previous inspection, but CQC said there was still limited assurance about safety and that management was inconsistent.
Medicines
Inspectors found that medicines were stored, administered and recorded safely. Staff training and competency checks were in place.
“People received their medicines safely and as prescribed.” from the report
Staffing
Inspectors found enough staff to meet people's needs. Staff were visible and available, including for people needing one-to-one support.
“There were enough staff at the home to meet people's needs.” from the report
Safety and cleanliness
The environment was safe and well maintained. Infection prevention arrangements were in place, although one occasion required extra prompting about protective equipment.
“The home was clean and hygienic. Cleaning schedules and products had been appropriately reviewed and enhanced in response to COVID-19.” from the report
Respectful care
People and relatives gave positive feedback about staff, describing them as polite, caring, friendly and supportive.
“People living at the home and their relatives gave positive feedback about the staff.” from the report
Progress since the last inspection
The provider had addressed the previous breaches relating to medicines, risk management and governance. CQC found the provider was no longer in breach of those regulations at this inspection.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Incomplete monitoring records
needs fixingFood, fluid and weight records were not always completed as often as planned. This could make it harder to show that people's health needs were being monitored consistently.
“The consistency and quality of record keeping still required improvement.” from the report
Unclear improvement actions
needs fixingSome quality checks identified actions, but it was not always clear who had to complete them or when they should be reviewed.
“There was a lack of clarity about who was responsible for ensuring an action was completed and some actions were recorded as 'ongoing' without a planned completion or review date.” from the report
Reliance on agency staff
minorThe home used some agency staff. Inspectors said this could make it harder to maintain consistent, high-quality records and sustain improvements.
“The home was reliant on some agency staff, albeit agency staff who were familiar with the home and worked there on a regular basis.” from the report
Protective equipment prompting
minorMost staff used the required protective equipment, but one occasion needed additional prompting about the appropriate levels.
“However, there was an occasion when staff needed additional prompting regarding the appropriate levels of PPE needed.” from the report
- 01How do you now make sure food, fluid and weight records are completed as planned?
- 02Who is responsible for each action identified by your quality checks, and what is the completion date?
- 03How are you reducing the effect of agency staff on consistent record keeping?
- 04What checks are made to ensure all staff use the correct levels of protective equipment?
- 05What were the ratings for Effective, Caring and Responsive at the previous comprehensive inspection?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 19 June 2021 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, November 2020
Turner Home was rated Requires Improvement; inspectors found serious risks with medicines, risk management and leadership, which was rated Inadequate.
This was an unannounced focused inspection on 29 September 2020. Inspectors checked whether the home had acted on its previous improvement plan. They looked only at Safe and Well-led. Effective was not inspected during this visit.
Inspectors found that risks were not properly assessed or explained in care records. An unsecured medicines trolley was accessed by a person, who took an overdose and was taken to hospital. Some people also did not receive important medicines as prescribed.
There were enough staff visible during the inspection, and people described staff as kind and helpful. The home was clean and infection control measures were in place. However, quality checks had not found or fixed the serious problems.
The overall rating remained Requires Improvement. Safe was Requires Improvement and Well-led had fallen from Requires Improvement to Inadequate. This was the fifth consecutive overall rating of Requires Improvement or Inadequate.
Staff availability
People said there were enough staff. Inspectors saw staff around the home, and people needing help were supported promptly.
“Staff were visible around the home throughout our inspection and people who needed assistance were promptly supported by staff.” from the report
Kind interactions
Inspectors saw kind and caring interactions between staff and people living at the home.
“We observed kind and caring interactions between staff and the people who lived at the home.” from the report
Cleanliness and infection control
The home was clean. Staff followed infection control practices and extra measures were in place for COVID-19.
“The home was clean and staff maintained good standards of hygiene.” from the report
Safeguarding awareness
Staff had received safeguarding training and understood how to recognise and report concerns.
“Staff had received safeguarding training and understood their role in recognising and reporting safeguarding concerns.” from the report
Unmanaged risks
seriousRisk assessments did not give staff enough practical guidance. This contributed to a person accessing an unsecured medicines trolley and taking an overdose.
“Risks associated with people's care were not adequately assessed, monitored and managed.” from the report
Medicines safety
seriousA medicines trolley was left unsecured, and some people did not receive essential or time-critical medicines as prescribed.
“Medicines were not safely managed which placed people at risk of harm.” from the report
Weak quality checks
seriousThe home's audits had not identified or corrected poor risk management and medicines problems. This was a continued breach and the fourth consecutive inspection with a breach of this regulation.
“Quality assurance processes at the home remained ineffective and placed people at risk of unnecessary and avoidable harm.” from the report
- 01How are you now assessing and recording each person's risks, including risks of self-harm or substance misuse?
- 02How do you ensure medicines trolleys are always secured and never left unattended?
- 03What checks now confirm that essential and time-critical medicines are given correctly?
- 04What evidence can you show that the new care-plan reviews and staff competency checks are working?
- 05How are managers addressing the continued breach of Regulation 17 and the Inadequate Well-led rating?
This was a focused inspection of Safe and Well-led only; Effective was not inspected and the other ratings used in the overall rating carried over from the previous inspection. This explanation was written from the published report of 12 November 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 Turner Home
6 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- June 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
- July 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2018Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: InadequateWell-led: Inadequate
- October 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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