Tenlands Care Home

Updated 11 February 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 27 January 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 11 February 2022

The inspection took place on 20 and 26 June 2018 and was unannounced. At our last inspection in April 2016 we awarded an overall rating of Good. At this inspection we found the provider had improved and was now rated Outstanding.

Tenlands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates 39 people across two floors. At the time of the inspection 34 people were being supported in the home, 16 of which required nursing care.

At the time of the inspection the service had a registered manager in post. ‘A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

People received exceptional end of life care which was personal to them and their relatives. Relatives felt staff provided excellent care and support and demonstrated a high level of compassion and kindness to people at the end of their lives. Relatives were supported during the time up to and following the death of their loved ones.

People, relatives and staff we spoke with, told us the service was extremely well-led and managed. A vision to drive improvement was central to the service’s ethos and this was evidenced in the quality assurance system along with the actions of the registered manager and staff across the service.

Staff were particulary positive about the registered manager. They confirmed they felt supported and could raise concerns at any time. We observed the registered manager was visible in the service and found they interacted with people and their relatives in an open friendly manner. People and relatives felt the management of the home was extremely positive. The provider recognised the importance of staff input by regularly giving out achievement awards.

Staff were aware of safeguarding processes and knew how to raise their concerns. Where lessons could be learnt from safeguarding these were used to improve the quality of the service. Accidents and incidents were recorded in detail and monitored as part of the provider’s audit process.

Medicines were administered by trained staff who had their competencies to administer medicines checked regularly. Policies and procedures were in place for safe handling of medicines for staff to refer to for information and guidance.

The provider ensured appropriate health and safety checks were completed. We found up to date certificates were in place which reflected fire inspections and gas safety checks.

Recruitment processes were in place with necessary checks completed before staff commenced employment. The provider checked nurse’s personal identification numbers (PINs) to ensure they were up to date. Staff completed an induction into the home on commencement of their employment. Inductions included mandatory training and an introduction in the provider’s policies and procedures.

Staff levels were appropriate to the needs of people using the service. The provider used a dependency tool to ensure staff levels met the needs of the people living in Tenlands.

Risks to people and the environment were assessed and plans put in place to mitigate against these. The provider had a continuity plan in place for staff guidance in case of an emergency. Personal Emergency Evacuation Plans (PEEPS) in place for people which were updated regularly providing support and guidance for staff in case of an emergency.

The provider used best practice and current legislation when assessing people’s needs to develop effective outcomes.

Where people were at risk of poor nutrition, risk assessments were in place with associated care plans to provide support and guidance for staff to follow. Specialist diets were provided for people with specific needs.

Staff received regular supervision and an annual appraisal. Opportunities were available for staff to discuss performance and development. Staff’s mandatory training was up to date. The provider’s training system covered clinical training and support for nurses.

Staff understood the Mental Capacity Act and gained consent prior to any care being delivered. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice

People and relatives felt the service was caring. Staff provided support in a respectful manner ensuring people’s privacy and dignity was acknowledged and promoted. Staff encouraged people to be as independent as possible. Equality and diversity was acknowledged by staff. Staff knew people well and understood their care and support needs. Information about advocacy services was accessible to people and visitors.

Care plans were in place setting out individual needs, likes, dislikes and preferences. People and relatives were involved in care planning where ever possible. Care plans were reviewed and updated whenever there was a change in need.

People enjoyed a range of activities both inside and outside the home. The service had positive links with the community with people accessing local landmarks and shops.

The provider had a complaints process in place which was accessible to people and relatives. Compliments were recorded and cards of thanks were available.

The premises were suited to people’s needs, with dining and communal spaces for people to socialise. Bedrooms were personalised to people’s individual taste, containing personal effects and pieces of furniture brought from home. Bathrooms were designed to incorporate needs of the people living at the home. The garden area was well kept and accessible to people and relatives.

The provider worked closely with outside agencies and other stakeholders such as commissioners and social workers. The registered manager attended best practice groups to drive improvement sharing learning with the staff team in order to improve outcomes for people. Statutory notifications were submitted to CQC. People’s personal records were held securely.