Tenby House

We found the following examples of good practice.

People were well supported by staff to maintain contact with their family and loved ones. People had been supported with video calls when visiting was not possible. The service facilitated in person visits in a manner which minimised the risk of infection spread. A dedicated visiting room was well laid out with screening in place. Relatives were required to undertake Lateral Flow Devices (LFD) COVID-19 tests before the visit commenced.

Social distancing guidelines had been put into practice by staff. Staff were encouraged to use all areas of the service while the management team had used communal spaces creatively for people to relax, spend time and dine with other residents safely.

Staff wore PPE when undertaking any personal care and around the home; this was disposed of safely. Many people who were living with dementia were unable to understand the restrictions imposed by the COVID-19 pandemic. Staff supported them sensitively and carefully to ensure social distancing guidelines were adhered to in a way that protected them and others at the home.

The management team had carefully considered zoning and cohorting in the event of a potential outbreak and demonstrated the changes that would be implemented under the provider’s contingency plan, if it was required.

The home was clean and hygienic throughout. A structured cleaning schedule was in place and cleaning regimes were adhered to so that all areas of the home were cleaned effectively.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

People felt safe living at the home. Staff had been trained to recognise the signs of potential abuse and new what action to take. Risks to people had been identified and assessed and actions taken by staff to mitigate risks. Staffing levels were safe and checks completed on staff before they commenced employment. Medicines were managed safely and people received their medicines as prescribed. The home was clean and staff wore protective clothing such as aprons and gloves, to prevent the risk of infection. Lessons were learned when things went wrong.

People received effective care from staff who had completed a range of training and had regular supervisions. People enjoyed the food on offer at the home and had a choice of menu. Healthcare professionals and support were provided for people as needed. There were ongoing plans to improve the building and people were involved in choosing colours when redecoration took place. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were looked after by kind and caring staff who knew them well. People were involved in all aspects of their care and had choices over their lives. Staff treated people with respect and compassion and were given the privacy they needed.

Personalised care was delivered to people that was responsive to their needs. Care plans provided detailed information about people, including their preferences and life histories. People’s cultural and religious needs were documented and their spiritual needs were met. Activities were organised at the home if people wished to participate. External entertainers also visited the home. People were happy at the home and had no complaints. Where complaints had been received, these were dealt with satisfactorily by the provider. People’s wishes for their end of life care were documented.

People spoke positively about the management of the home and their feedback and views were obtained in a variety of ways. Relatives’ feedback was sought and positive comments had been recorded. Staff felt valued in their roles and supported by management. Systems were effective in measuring the quality of the service and to drive improvement. The service met all relevant fundamental standards.

Further information is in the detailed findings below.

We observed people being treated with respect and kindness and the atmosphere was a happy and relaxed one. All those we spoke to said they liked living there. All staff we spoke to said they were happy working there.

We looked in people's care records and found that comprehensive assessments and care plans were in place. We saw risk plans documented and evidence of specialist interventions where appropriate. We also observed that their cultural, religious and language needs had been addressed.

We saw evidence that relatives were asked for their views on standards of care at Tenby House and that they were involved in their relative's on gong care.

We found that the provider had safeguarding procedures in place and that all staff spoken to were able to describe these procedures and had received appropriate training. We saw a training data base and training certificates to evidence this.

We looked at staff records that were all well organised. All demonstrated that suitable checks and references had been made prior to commencing and that all had received a comprehensive induction programme. Rotas demonstrated appropriate numbers of staff on duty and the staff we spoke to all stated they felt confident and supported in carrying out their role.

We read in people's care plans that their likes and dislikes were taken into account. We spoke to carers, who told us that they had been involved in people's assessments and care plans. We looked at a carers' survey and found that relatives were involved in people's care. In cases where people lacked mental capacity, we found that appropriate arrangements had been made to protect their rights and interests.

We read people's case records and saw that there were appropriate and personalised care plans in place and specialist services were included in people's care. We saw evidence that people's diverse cultural, religious and language needs had been addressed.

We saw that the provider had suitable safeguarding procedures in place and that these had been used when needed. We saw that staff had been trained in safeguarding and this was confirmed to us by staff we spoke to. We spoke to carers and they said that their relatives were safe.

We saw that staff had received training appropriate to their roles, including specialist training such as dementia, and that this was updated as necessary.

We saw a range of quality assurance audits and found that service improvements were being made as a result.