Tenlands Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this service under this provider. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager encouraged an open culture of continuous learning. Accidents and incidents were recorded accurately, and action was taken to minimise potential future risks. Learning was embedded through reflective practice and partnership working. Staff actively engaged with external health and social care professionals to review care and respond to any concerns. There was a strong emphasis on learning from events, feedback and best practice, which supported continuous improvement and helped to sustain a safe service.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff worked closely with health and social care professionals to ensure people received the care and support they needed. This included sharing information when people transferred back to their own homes or other care facilities. There was effective communication between staff, health and social care professionals and people’s families. A relative told us, “I’ve always been informed if [family member] is under the weather.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and relatives felt the home was safe. One person said, “The staff are lovely and I definitely feel safe.” A relative told us, “I am sure they’re safe here. I couldn’t manage with them at home anymore, but I visit a lot and don’t need to worry about them.”

Safeguarding concerns were reported and investigated appropriately. Staff had completed safeguarding training, knew how to identify and report potential issues and felt confident doing so.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. DoLS authorisations were in place for people where appropriate. There was effective oversight of DoLS applications, authorisations and any associated conditions.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Individual and environmental risks were identified and managed. Care plans outlined how best to mitigate each risk and guided staff how to support people to remain safe. These were reviewed regularly to ensure the information remained accurate and complete. Staff supported people to take positive risks where appropriate. Staff involved people and relatives in decisions about their care, including choices about daily living, activities and personal preferences.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The environment was clean and well maintained. Safety checks of the premises and equipment were completed regularly. Procedures were in place for emergency situations and these were reviewed and updated regularly.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staffing levels were monitored to ensure people received safe and timely care. During our visit we saw several people were distressed due to their individual health needs; staff supported them promptly and sensitively.

Staff were recruited safely. Recruitment checks included obtaining references from previous employers and carrying out relevant checks to ensure applicants were suitable to work with vulnerable adults.

Staff had completed training and supervision relevant to their roles and told us they were well supported by the management team. A relative said, “Staff are always attentive and seem highly trained.”

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of infection spreading. We found a cupboard in a downstairs shower room contained clean linen and a laundry trolley was stored there, which did not promote effective infection and prevention control. When we spoke to the management team about this they took immediate action to rectify this and began re-purposing an existing store room so there could be more effective measures to prevent infections spreading. The rest of the home was clean and tidy.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Where people were prescribed ‘when required’ medicines, such as pain relief or medicines to support good bowel health, some care records needed more detail to guide staff when these should be administered, in which order, and how this should be monitored. When such medicines had been administered, records did not always evidence why they had been needed and how effective these medicines had been. This is important for monitoring people’s health needs and escalating to health professionals if necessary. When we discussed this with the registered manager and regional manager they took immediate action to rectify this.

Body maps to guide staff where prescribed topical medicines needed to be applied were not in place for the current medicines cycle, which had started recently. The deputy manager advised this was an oversight and rectified this immediately. We found no evidence that people did not receive their medicines as prescribed, as staff could tell us when people needed ‘when required’ medicines and where they needed their prescribed topical medicines applying. Records and checks of stock levels confirmed medicines had been given as directed, so we were assured that people received their medicines as prescribed.

There were appropriate arrangements for ordering, storage and disposal, including for medicines needing cold storage and those requiring extra security. Suitable temperature monitoring was carried out to make sure medicines storage was safe and effective. Where people were able to administer their own medicines, this was supported and managed appropriately.