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Tennyson Wharf Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 2 March 2017

This inspection took place on 18 January 2017 and was unannounced. Tennyson Wharf provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 60 people who require personal and nursing care. At the time of our inspection there were 46 people living at the home. The service is provided across three floors and divided into five units providing specific care to people, for example one of the units provided care to people living with dementia.

There was a registered manager in post. 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.

On the day of our inspection staff interacted well with people. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe from abuse including financial abuse.

Medicine records and guidance were not consistent. Protocols were not consistently in place for as required (PRN) medicines. Medicine administration sheets did not clearly identify when medicines were PRN.

We saw that staff obtained people’s consent before providing care to them. The provider did not consistently act in accordance with the Mental Capacity Act 2005 (MCA). Best interests assessments were not clearly documented. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the Deprivation of liberty Safeguards (DoLS) and to report on what we find. We found that the provider acted in accordance with DoLS.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

People in the downstairs unit said response times were sometimes slow. We found there were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support.

Staff had the knowledge and skills they needed to care for people in the right way and they had received most of the training and guidance they needed. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received supervision. People were encouraged to enjoy a range of social activities. They were supported to maintain relationships that were important to them.

Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Regular audits were carried out and action plans put in place to address any issues which were identified. Accidents and incidents were recorded and investigated. The provider had sent us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.

Inspection areas

Safe

Requires improvement

Updated 2 March 2017

The service was not consistently safe.

As required (PRN) protocols were not consistently in place. Medicine administration sheets did not clearly detail when medicines were required on a PRN basis.

Risk assessments were completed.

There were sufficient staff to provide safe care.

Staff were aware of how to keep people safe. People felt safe living at the home.

Effective

Requires improvement

Updated 2 March 2017

The service was not consistently effective.

The provider did not act in accordance with the Mental Capacity Act 2005.

Staff received regular supervision. Training was provided to ensure staff had the appropriate skills to meet people’s needs.

People had their nutritional needs met.

People had access to a range of healthcare services and professionals.

Caring

Good

Updated 2 March 2017

The service was caring

People’s privacy and dignity was respected. Care was provided in an appropriate manner.

Staff responded to people in a kind and sensitive manner.

People were involved in planning their care and able to make choices about how care was delivered.

Responsive

Good

Updated 2 March 2017

The service was responsive.

Care records were personalised and reviewed regularly.

People had access to activities and leisure pursuits.

The complaints procedure was on display and people knew how to make a complaint.

People were aware of their care plans.

Well-led

Good

Updated 2 March 2017

The service was well led.

There were systems and processes in place to check the quality of care and improve the service.

The registered manager created an open culture and supported staff. Staff understood their roles and responsibilities.