CQC report explained · a residential care home
What the CQC found at Twynham
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, risks, emergencies and infection control were managed, and infection control had improved since the previous inspection.
- Effective?
- Good
- This key question was not assessed in this inspection.
- Caring?
- Good
- This key question was not assessed in this inspection.
- Responsive?
- Good
- This key question was not assessed in this inspection.
- Well-led?
- Good
- The home had an open culture and regular quality checks. Inspectors found that managers understood their responsibilities and acted on issues identified through audits.
What inspectors found, October 2022
Twynham rated Good; inspectors found safe care and effective leadership, but staff shortages and mixed training feedback need attention.
Inspectors visited on 26 August 2022. They spoke with people, the manager, staff, relatives and an external professional. They also checked care, medicines, incident, training, activity and quality records.
The home was rated Good overall. Safe was rated Good and had improved to this rating. People said they felt safe, medicines were managed safely, risks were assessed, and infection control had improved.
Inspectors also rated the home Good for being well-led. They found regular checks on care, medicines, training, safety and infection control. The home was recruiting permanent staff and using regular agency staff, although staff said more permanent staff were needed.
Improved infection control
Inspectors found better infection control than at the previous inspection. The home had enhanced cleaning, hand gel and protective equipment arrangements.
“At this inspection we found improvements had been made.” from the report
Safe medicines systems
Staff were trained to give medicines. Records were complete and matched the medicines checked by inspectors.
“People's MAR charts were completed correctly, contained no gaps in recording and matched the medicines stocks we checked.” from the report
People felt safe
People and relatives told inspectors they felt assured about safety. Safeguarding procedures were up to date and staff knew how to report concerns.
“People told us they felt safe.” from the report
Regular quality checks
The manager carried out checks on areas including health and safety, training, medicines, infection control, complaints and care records. Actions had named responsibilities and completion dates.
“The registered manager undertook and coordinated a range of quality audits across the service.” from the report
Permanent staff vacancies
needs fixingStaff consistently said more permanent staff were needed. The home was using regular agency workers while recruiting, and staff feedback said staffing levels could sometimes be difficult to maintain.
“Staff consistently commented additional permanent staff were needed in the home.” from the report
Mixed behaviour-support training
needs fixingStaff gave mixed feedback about whether they had enough training to support people when behaviour was challenging. Some staff said further training had been arranged, but another said training was not initially sufficient.
“In my opinion when a new service user arrived that was challenging, we did not have the training that was needed to keep everybody safe.” from the report
- 01How many permanent staff vacancies are there now, and how often are regular agency staff being used?
- 02What training must staff complete before supporting someone whose behaviour can be challenging?
- 03How do you check that staff remain confident and competent in physical intervention and positive behaviour support?
- 04What infection control improvements made after the previous inspection are still in place?
- 05How are families told about incidents and the actions taken afterwards?
This inspection assessed Safe and Well-led only; Effective, Caring and Responsive were not rated in this report. This explanation was written from the published report of 1 October 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, January 2018
Twynham was rated Good overall; inspectors found kind, personalised care, but safety needs improvement.
Inspectors visited the home without notice on 9 and 10 November 2017. They spoke with people living there, relatives, staff and health professionals. They also checked care plans, medicines, recruitment files and management records.
People were generally supported well. Inspectors found kind and respectful staff, personalised care plans, good support with food and health needs, and a wide choice of activities. People were involved in decisions and were encouraged to be independent.
The main weakness was safety. Some areas needed refurbishment and created an infection control risk. Automatic fire door guards had not worked since August 2017, and the response to this problem was too slow. The overall Good rating means the home met the inspection standards overall, but Safe was rated Requires Improvement.
Kind and respectful staff
People were treated with compassion, privacy and dignity. Staff adapted how they communicated and encouraged people to do things for themselves.
“People were cared for with kindness and compassion.” from the report
Personalised support
Care plans gave staff detailed information about people's needs, communication and preferences. People were involved in planning and reviewing their support.
“Care plans provided comprehensive information about how people wished to receive care and support.” from the report
Choice and activities
People chose their activities and could change their minds. The home supported outings, holidays, hobbies and opportunities for greater independence.
“People were supported and encouraged to make choices and had access to a range of activities.” from the report
Supportive management
Staff said they felt supported by management. Regular meetings and audits were used to discuss concerns and monitor the service.
“There was an open and transparent culture within the home.” from the report
Infection control and building condition
seriousSome areas needed refurbishment and presented an infection control risk. Inspectors noted an unpleasant odour, stained flooring and a rusty radiator in bathrooms.
“Not all infection control risks had been identified or rectified.” from the report
Fire door guards not working
seriousRecords showed that automatic fire door guards had not worked since August 2017. Inspectors found that the delay in responding to this known problem compromised people's safety.
“records showed door guards were not working since August 2017.” from the report
- 01Have the automatic fire door guards now been repaired, and when were they last tested?
- 02Has the planned refurbishment of the bathrooms and replacement of rusty radiators been completed?
- 03How are infection control problems now identified, recorded and followed up?
- 04How quickly are safety problems reported to senior managers and checked until they are fixed?
- 05How will you make sure staffing remains sufficient when people need individual support for activities or changes in their health?
This was an unannounced inspection covering the premises and care, with ratings given for all five CQC questions; it was the first inspection under the registered provider. This explanation was written from the published report of 6 January 2018 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 Twynham
2 rated inspections over 5 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2018GoodSafe: Requires improvementWell-led: Good
- October 2016
Registered with the Care Quality Commission on 10 October 2016.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
26 live-in carers within about an hour of Hampshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.