Tower Bridge Care Centre

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.This is the first inspection for this service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People had care plans in place, and they told us they were involved in the planning and reviewing of these. Relatives were kept up to date on people’s health and wellbeing if there were any incidents or changes that required notification. Some care plans did not have information about people’s protected characteristics under the Equality Act. While we saw no evidence to indicate this directly affected people’s care some people did tell us they were experiencing isolation. Some people did not have their social or emotional needs met and told us they experienced isolation at the service. This was happening despite the service having measures in place, like bringing social events to the home and by arranging trips to the community. This meant people were at risk of harm and avoidable harm by not receiving person centred care to prevent isolation.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. The provider worked well with services in the local community, so people were able to access activities outside of the home. There were many pictorial notice boards in the service informing people of activities that were taking place within the service, as well as community activities. People’s relatives told us they were informed of activities their relatives could attend. Healthcare professionals we spoke to at the inspection told us they felt the service worked well with them, and that staff and the registered manager always take on board any advice or comments made to improve the care or wellbeing for people using the service.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to people’s individual needs. The service had a robust accessible information standard policy in place. They ensured people were able to receive information in a way that was accessible to them, tailored to individual needs. One relative told us, “This is a [staff member] who speaks [relatives’] language and that helps,” and “The [staff] treat my relative very well. It helps that one of the [staff] speaks [relative’s] language. The service had a system where staff were able to access care plans on devices which were secured with a password. The manager’s system was also secured with passwords so only authorised staff could access this.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Most people we spoke to knew who the registered manager was. All the relatives we spoke to told us they knew who the registered manager and the management team in the service were. They told us they were confident that if they raised a complaint, it would be taken seriously and managed affectively. The service had a complaints policy in place. Complaints were documented and investigated; and the provider exercised duty of candour when things went wrong. Concerns were discussed at team meetings, and preventative measures were discussed to aid learning and prevent repetition.

The provider made sure that people could access the care, support and treatment they needed when they needed it and any delays in treatment was followed up quickly by the registered manager. The service had a GP on site every weekday, and a GP was on call throughout the weekend. We spoke to a GP working in the home and was told that the service worked well to ensure people have access to care as and when they need it without delay. Care plans documented people’s needs and reasonable adjustments that were required. People had personal emergency evacuation plans in place to ensure all people could be evacuated or kept safe until they were able to be evacuated in the case of an emergency.

Staff did not always actively prevent inequality in experience or outcomes for those who were most likely to experience this. We received mixed feedback from people. One person told us, “I’m stuck in here all day. Id’ like to go outside, but they can’t afford to let [staff] go with me.” Another person said, “I tell staff I want this, and I want that, and I don’t hear anything. They are OK they just don’t follow up.” We found people were at risk of inequality of good outcomes dependent on their mobility support needs, which left people at risk of being left out of social activities, and activities important to wellbeing and health. However, we also received positive feedback like, “[Staff] are a wonder. A member of staff kindly made a little garden for my relative as [staff] know how much my relative loved [their] garden,” and “The staff are nice. When they come and chat to me it lifts me up. I do have friends that visit which also helps.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Care plans were designed so people could document their advanced care plans if they wished to do so. Staff had received training in end-of-life care. The service had designed end of life boxes, so when required staff would have immediate access to all of the equipment, they might need in that scenario. The service had a robust end of life policy in place. The policy detailed beliefs and practices from a range of religions in relation to advanced care, to ensure staff were aware of how to support people to with good and personalised end of life care.