Twyford House

This report from the Care Quality Commission (CQC) provides an overview of Twyford House following an inspection. The inspection focused on key areas to assess the quality of care provided, particularly in relation to 'Right Support, Right Care, Right Culture' principles. It identifies specific areas where improvements are needed to ensure residents receive the best possible care and support, while also noting where good practices are in place. The findings aim to help families understand the service's current performance and identify areas for potential development.

On safety, the service needs to improve how it assesses and manages risks for residents. While staff are trained to recognise abuse and report concerns, care plans are not always updated following incidents to reduce future risks. There were also issues with ensuring agency staff receive adequate induction and that risk assessments, including emergency evacuation plans, are kept up-to-date. Medication management and infection control practices were found to be safe and effective.

In terms of how effective the care is, staff understand how to protect residents from abuse. However, residents' views about the service and the support provided were not always sought, meaning people did not always have a voice in their own care. While some staff interactions were positive, there were instances where residents experienced long periods without staff engagement, and communication could be more person-centred.

Regarding how caring the service is, staff are trained to recognise and report abuse. However, there were times when staff turnover was high, impacting the consistency of care. Some staff interactions observed and reported showed a lack of kindness, dignity, and respect in how people were spoken to. Despite this, residents were supported with their medicines to promote independence.

In relation to how responsive the service is, people did not always have maximum possible choice, control, and independence. Residents' views about the service and support were not consistently sought, meaning they often did not have a say in their own care. The service's size was noted as larger than current best practice guidance.

Finally, looking at how well-led the service is, governance processes were not always effective, with audits not always leading to improvements. Leadership needed strengthening, particularly in providing robust induction for new staff. While the registered manager is aware of their responsibilities, there is a need to foster a more positive and consistently person-centred culture, as feedback from staff indicated tensions within the team and some dissatisfaction. Relatives reported positive communication when things went wrong.