Tower Bridge Care Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. This is the first inspection for this service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

This service scored 61 (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 did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities. We saw some people who required additional support with mobility have less access to activities in relation to their peers who could mobilise independently. One person had their bedtime adjusted against their wishes, meaning they missed out on socialising with their peers during the evenings. This meant the service did not ensure people were treated with equality in line with their human rights. However, the provider did have active goals of improving the service. The management team attended multi discipline meetings on a regular basis to learn and share ideas all aimed at improving the experience of people using the service. The services policies were in line with current best practice guidance, and minutes of meetings showed discussions around improvement were shared with staff, and people’s relatives. The management team carried out audits for all aspects of the service attempting to mitigate any risk and improve the service.

The context in which the provider delivered care, treatment and support did not lead to positive experiences for all people using the service. While the leadership team had a good knowledge of all of the people using the service, and they were able to tell us about peoples support needs at the inspection without referring to their notes, measures were not put in place to protect people from isolation. People told us they were not able to access the garden, or the community, and some people were not able to take part in activities in the home. This meant people using the service did not experience care and support that was compassionate or felt inclusive.

Staff told us they felt the management team were approachable and they led by example. One member of staff said, “We had some issues before, but the new [registered] manager is sorting them out.” The registered manager told us they were well supported by higher management team which made it easier to try and achieve good outcomes for people. We saw accidents and incidents were documented and reviewed. Lessons learned where shared, and management were honest and open about when things had gone wrong.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us they were happy to raise concerns with the registered manager, and they were confident these would be looked into. Where necessary, concerns would be treated confidentially. The service had a complaints policy in place, which listed the process of how complaints could be made, and what they should expect. The policy also listed a range of services staff could complain to outside of the service if they felt the need to do this. People and their relatives told us they were able to contact the registered manager to raise concerns if required.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.The registered manager was supported by the provider and senior management to take decisive action to improve disparities in relation to experiences of staff from marginalised groups. The action of the registered manager prevented the risk of institutionalised discrimination and bias in relation to staffing. The registered manager told us they were fully supported by senior management which ensured equality and fairness across the workforce which enabled their wellbeing to be maintained. Staff told us they were treated fairly, and they no longer hand any concerns about their treatment or that of other staff.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. We received negative feedback from people in relation to the independence and control of how they managed their daily lives, and of feeling that some staff were not caring towards them. This meant despite the systems in place to protect people, some people’s quality of care did not achieve good outcomes, and these concerns were not picked up or addressed until this inspection. The ongoing issue with mice in the building had not been addressed effectively, and the pest control reports told us that the provider had not taken recommended steps to manage this concern prior to the inspection.

Staff and people told us they thought the service was well organised. One relative said, “It is an organised and relaxed service.” Another person said, “I think things seem well organised.” Records were securely kept and easily accessible by relevant staff. Audits were carried out on all aspects of the service on a regular basis. The service had a comprehensive business continuity plan in place. The provider ensured statutory and regulatory notifications were sent as required to the local authorities or CQC.

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The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. The provider worked with a range of services and charities in the community to support people’s wellbeing. People were able to access to the communities and attend church services, theatre, cafes and community groups. Musicians attended the home to entertain people. The service also had a hairdresser on site, and a chiropodist who would attend to give people easier access to these treatments. The service worked closely with local educational services and visits of young people; toddlers and their parents were arranged. One person said, “The local nursery comes here – it’s lovely seeing all of the children. That cheers me up. They put on a pantomime at Christmas which was lovely.” A relative told us, “My relative likes joining in everything on offer. [Relative] is very social and loves being with people. [Relative] loves the sing-along and music. They have quite a few volunteers who visit regularly and speak to [people]. We all go down to the community hub; it is really nice. The volunteers are regular, so they have a really good rapport with the residents, we all have a laugh which is so important.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. The provider encouraged creative ways of delivering equality of experience, outcome and quality of life for people. The service held quarterly meetings with relatives where issues, concerns and ideas were discussed and fed back to the management team. Relatives told us these meetings took place, and if they were not able to attend, they received minutes so they could catch up on what was discussed. The service had strong external relationships and health professionals who spoke positively about the and told us the management team and staff were responsive to taking advice to actively improve the service.