Archived: Tamerine

Staff were observed to engage people with activities and to treat people with kindness.

The home worked with health and social care professionals such as community nursing services and social services staff to meet people's needs. We spoke to two social services' staff, which included those who commissioned services from the home. They told us the standard of care at the home was good and the home provided valued support to people and their families. Comments made by these professionals included: 'It is a very reliable and trustworthy service,' and, 'The manager and staff are creative in finding solutions to meet people's needs.'

We also used this inspection to answer our five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

Is the service safe?

The home had policies and procedures regarding the safeguarding of vulnerable adults. Staff were aware of the need to protect vulnerable people from possible harm and knew what to do if they had any concerns about the welfare of people.

The registered manager had a good awareness of the Mental Capacity Act 2005 and staff had received training in this. Assessments of people's capacity to consent to care and treatment had been carried out where appropriate. Where people were unable to consent to care and treatment and, decisions were made on their behalf, a 'best interests' care plan was completed. Applications to social services for a Deprivation of Liberty Safeguards (DoLS) authorisation were made when people were restricted to keep them safe, such as by the use of bed rails.

Risk assessments were completed where people were identified as being at risk of injury so staff knew what to do to keep people safe when activities were undertaken.

The home had sufficient numbers of staff to keep people safe.

Is the service effective?

Staff had the skills and knowledge to provide effective care. There was a comprehensive programme of relevant courses for staff to attend. Staff said they were supported in their work and had regular supervision with their manager.

The premises were adapted for people who had a physical disability so people could safely move around the home. There were areas where people were observed taking part in activities. People had personalised their rooms as well as the communal areas.

Relatives told us the home provided effective care. One relative said their son/daughter loved going to the home and was fond of the staff.

Is the service caring?

We observed staff talking to people in a calm and patient manner. Residents were comfortable approaching staff who responded to people with warmth and humour. Staff expressed a commitment to providing a caring service. One staff member said, 'It is the type of home we (the staff) would be happy for any of our relatives to live in. We try to provide care to the standard we would give to one of our relatives.'

Relatives of people who lived at the home said the staff were caring a kind.

People's records and care plans were personalised to reflect how people wanted to be treated. Staff involved people as far as is possible in decisions about people's care.

Is the service responsive?

The registered manager and staff arranged staffing levels and care in response to each person's needs. Activities were provided to people based on what people liked to do. Care plans reflected each person's individual needs and the staff had involved people in decisions about their care and day to day life at the home.

Social services' staff told us the home excelled at providing a responsive service to people and their families.

Information was provided to people and their relatives about the service provision. This included the complaints procedure.

Is the service well led?

The home was well led with a range of quality assurance checks which included audits of care records and observations of care provision. The views of people and their relatives were sought so improvements could be made to the home.

There were communication systems so staff were aware of policy and practice issues regarding safe and effective care.

Incidents and accidents were investigated and action taken to prevent any possible reoccurrence.

Health and social care professionals told us the registered manager and staff worked with them to meet people's needs.

During our visit there were two people using the service. We spoke with one person who used the service, one relative and observed the way staff interacted with both people. We observed staff responding to requests for assistance and joining in activities such as playing drums and other instruments.

We spoke with one person using the service and they told us they were offered choices about their care and support. They felt that staff were kind and understanding. They said 'I talk to staff and they try and help me.' A relative told us that they were happy with the care and they thought the staff were 'All very helpful.' They said their relative was very happy when they were at Tamerine.

A senior manager from Southern Health visited the home regularly to assess the quality of the service provided. A number of audits were completed; these included a finance audit, a compliance audit and a health and safety tool. All were completed on a quarterly basis with the last audit being carried out on 3 February 2014. We saw that actions had been addressed.

During the visit we spoke with one person who used the service and observed the way staff interacted with other people. The person we spoke with told us that staff checked with them before providing any support to make sure they were happy with what was planned. The person said they were able to say they didn't want care or support at certain times and staff respected this. We observed staff asking people who used the service for their consent to provide support to them.

People experienced care, treatment and support that met their needs. However, people's care plans did not always reflect the level of support they required or risks to them. This increased the risk that people may not receive the care they needed.

The one person who used the service that we spoke with told us they felt safe and said they would talk to staff if they had any concerns. The person was confident that any concerns they raised would be taken seriously and staff would help them to resolve the issue.

People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The one person who used the service that we spoke with said they were able to raise concerns with the staff or manager and were confident that action would be taken to address the issue.

People told us that they received care from staff who were 'very good and friendly'. People expressed satisfaction with the care and support they were receiving. They commented that the staff were "nice" and respected their privacy and dignity. A person said they 'can't do what I want' but they understood the reasons why and had agreed to it. There was a variety of equipment available to support and maintain people's independence.

People were assessed prior to receiving care. Risk assessments and care plans were detailed and person centred. People said that they were treated with respect and were asked for their preferred form of address. They said that meals were very nice and the food choices were 'very good'.

People had access to healthcare professionals and treatment as needed. Appropriate arrangements were in place for the management of people's medicines. There was a robust recruitment procedure that the staff followed. Information on how to raise concerns was available to them and in appropriate formats. There was a process that looked at the quality of the service provision.