Tower Bridge Care Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People were involved in the assessment of their needs. The service allowed people to make decisions about the care and treatment they received and how this was delivered. Care plans contained up to date and accurate information. People’s communication needs were noted in their care plans. People had robust and personalised communication aids in place which involved pictures and instruction in peoples first language. The service had a robust accessible information standard policy in place, and we saw that staff was following and implementing this standard effectively. The service had picture displays in communal areas to aid peoples understanding of activities and services that were available, as well as meals that would be served throughout the day.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Care plans identified people’s complex care needs such as diabetic, and epilepsy care and special dietary requirements. Kitchen staff were aware of people’s dietary needs and ensured people’s meals were appropriate to what was stated on their care plans. While people were not involved in the planning of meals, they were offered a variety of choice for their meals and snacks and drinks. People told us they enjoyed the meals they received. We received comments like, “The food is pretty good. It’s my choice to eat lunch in my room. I get what I’m given. It’s all OK anyway,” and “[Relative] eats everything. Today [relative] had a cooked and cold breakfast. Everyone is catered for,” and “I think relative likes the food, they never complain about it.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs appropriately when people moved between different services. People had care plans in place which detailed their health care and support needs. This ensured any other services supporting people would have a good understanding of their health and care needs, avoiding people having to repeat their story. Staff had access to people’s care plans on electronic devices, so people’s information was quickly available. The management team attended multidisciplinary meetings on a regular basis, so they could learn from other services and sectors, and imbed learning within the service. We received good feedback from the health professionals we spoke to, who said they were happy working with staff and the management team. They told us, that staff and management were always willing to take advice and make adjustments to ensure the best for people’s health and well-being.

The provider did not always support people to manage their wellbeing, so people could not always maximise their independence, choice and control. We received mixed feedback from people who did not feel in control or were not able to exercise independence within the service. Some people with mobility support needs told us they felt isolated in the rooms. One person said, “I have always been active, but I don’t do anything here. I can’t go outside,” and “I am lucky that I have visitors. I sometimes hear about activities.” We discussed the issue of people telling us they felt isolated with the management team. They told us they would review the delegation of staff to ensure people were not isolated.

Some people and their relatives told us they were involved with the review of health and wellbeing needs. There was a GP at the service every weekday. The GP would focus on different floors on different days and prioritise people with immediate health needs across all floors as soon as possible.

Staff worked closely with external partners in managing conditions such as pressure ulcers, and staff had received relevant training. The service had records of healthcare appointments people attended and those that were due. One relative told us, “I can always get a doctor to see my relative, and I make sure I am here when the GP visits so I can speak with [them].

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Care plans and risk assessments were stored electronically and could be accessed using main computers, and handheld devised for staff to have easy access. Care plans covered needs such as moving and handling, skin care, communication, falls preventions, pressure ulcer prevention and management of nutritional needs. Most people told us that they felt supported by staff to achieve positive outcomes and access to social opportunities, however some people told us they felt isolated. We received comments like, “I am very isolated, I am stuck in my room all day,” and “I would like to get some fresh air and go out to the garden, but they don’t take you. I don’t think they have the time.” People’s feedback told us the service was not doing enough to reduce the risk of harm and avoidable harm in relation to people feeling isolated while living at the service.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff helped people understand their options in relation to care and support they needed. A staff member told us, “We get to know people as much as possible. We give them choices and ensure they understand that they have a choice.” While some staff were not able to confidently explain the principles of the mental capacity act, staff had received training and were gaining consent from people before they delivered care and treatment to them. A member of staff told us, “We always knock on doors before entering, then we introduce ourselves to people before delivering care.” Staff told us they had completed training in the mental capacity act. People confirmed staff always gained consent before delivering care and treatment.