A single inspector carried out this inspection. The focus of the inspection was to answer 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 people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
Staff were properly recruited and their personnel records contained all the information required by the Health and Social Care Act 2008. This meant that the provider had taken all reasonable precautions to ensure that they only employed people who had the right attitudes to be able to carry out their role in caring and supporting vulnerable adults. We saw that the home had a good training programme in place that meant that staff were taught the skills needed for their jobs. We were told that the training was regularly refreshed. One member of staff told us "I did not start work straight away, first I did many shifts shadowing a more experienced member of staff, then I did induction training. Now I do training every six to twelve months, I've done end of life and first aid training."
We monitored the administration of medication. We noted that this was done efficiently and we heard that only staff who had done their medication administration training were authorised to distribute the medication. However we also noted there were some lapses in the procedures to ensure security of medication. This meant that the home could not be sure that medication was always stored safely and we have asked the home to tell us what they plan to do to rectify the situation.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager knew when she needed to apply for a DoLS and told us that at the time of our inspection there was no one who needed this protection.
Is the service effective?
People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. One person who lived at the home told us "You don't need to inspect this home, I think they're pretty good carers." Another said "They mended my dress for me." A relative who was visiting told us "The care here is fantastic and so are the people who work here."
Is the service caring?
People were supported by kind and attentive staff. We saw that the care workers were patient and gave encouragement when supporting people. We also observed that staff had good relationships with people, sharing jokes and exchanging conversation as they passed. One visitor told us that their relative had become considerably more dependent since moving into the home. They described how there was always a member of staff available to help their relative with eating and to ensure that they drank enough. They went on to say "We've never seen any member of staff getting annoyed. We've never seen any unkindness, and there are always sufficient staff on duty. They have patience."
Is the service responsive?
People's needs had been assessed before they moved into the home. Records confirmed people's preferences and that care and support had been provided that met their needs. These were regularly reviewed and amended if necessary. A comprehensive verbal handover was given at the shift change-over. The handover demonstrated the real affection that people were held in by the staff team. One visitor explained how their relative was always supported to be ready if they let staff know when they planned to arrive. They went on to explain that they were encouraged to visit whenever they liked.
We were told that call bells were answered quickly. We observed that the bell was answered within a couple of minutes on two occasions.
Is the service well-led?
We were shown the home's internal quality assurance file that was regularly monitored by members of the management committee. This meant that the service was checked against the standards of the committee, so any shortcomings should be found at an early stage.
Equipment at the home had been well maintained and with one exception had been serviced regularly. (The testing of gas equipment was two months overdue. The manager was aware of this and was "chasing" for the tests to be done.) This meant that people were cared for in an environment that was safe.
We were told of an event held a few days before our visit. During the event people living at the home, their friends and families, and staff all mixed in small groups to discuss the running of the home. Senior staff moved from group to group listening to what was said and responding. The relatives we spoke with told us that "The management are approachable. They listen and deal with things. No fobbing off." People living in the home confirmed this saying "I think they really listen."
Small changes to the care home had been introduced as a response to feedback from the regularly held surveys and other information gathering events.
People living at Tamar House, and their visitors told us that they felt that the management of the home was honest and approachable and that they listened to their concerns.