Archived: Tenchley Manor Nursing Home

We found the following examples of good practice.

People told us they felt safe with the infection control and prevention measures that were in place. The layout of the communal areas were spacious and supported social distancing. The premises were clean and odour free. There was an enhanced cleaning regime in place which included regular sanitisation of high touch areas.

People and staff participated in regular whole home testing for Covid 19. Personal protective equipment (PPE) was readily available and there were PPE stations around the home for staff and people to use. Staff wore and used PPE appropriately and had received training in infection control processes. Staff were discouraged from wearing plastic aprons when moving through the service. This ensured fresh aprons were used for each engagement with people including personal care and mealtime support.

Visiting was in line with government guidance and had been adapted throughout the pandemic to ensure visiting was compliant with government guidelines. All visitors and contractors were required to undertake Lateral Flow Device (LFD) tests on arrival. PPE was a requirement of visiting and was readily available to visitors. The layout of the service had been adapted to support safe visiting.

When government guidance restricted visiting, and when the home was in lockdown due to an outbreak of Covid 19, people had been supported to stay in touch with relatives using video technology. This had enabled family gatherings to take place virtually and had proved to be a popular method of remaining in contact with loved ones.

The service had been proactive when considering the wellbeing of people during the pandemic. A range of activities were available, and people also made use of fully accessible garden area. There was a covered outside space with heating and a sun lounge which provided people with a change of environment. Activities were provided and had been adapted to support safe infection control and prevention and enhance people’s mental well-being and occupation.

Tenchley Manor Nursing Home is registered to provide accommodation and nursing care for up to 37 older people. At the time of our inspection, 29 people were living at the home. The home provides permanent placements and short-term breaks for older people with a variety of nursing and healthcare needs.

People’s experience of using this service:

• People received care and support that was safe. The provider continued to have a robust recruitment programme which meant all new staff were checked to ensure they were suitable to work with vulnerable people. All staff had received training in safeguarding people.

• There were risk assessments in place to identify any risk to people and staff understood the actions to take to ensure people were safe. There were enough staff to support people with their daily living and activities.

• People received effective care and support. Staff demonstrated a clear understanding of people's needs and received training relevant to their role and the needs of people living in the home. People enjoyed a healthy balanced and nutritious diet based on their preferences and health needs.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

• People received care from staff who were kind and caring. Staff respected people's privacy and dignity. Staff supported people to be fully involved in their care planning and reviews. People were supported to express an opinion about the care provided and the day to day running of the home.

• People received responsive care and support which was personalised to their individual needs and wishes and promoted independence. There was clear guidance for staff on how to support people in line with their personal wishes, likes and dislikes. People were supported to access health care services and to see healthcare professionals when necessary.

• People were supported by a team that was well led. The registered manager demonstrated an open and positive approach to learning and development. Staff said the registered manager was open to suggestions and approachable.

• There were systems to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people's views. Records showed the service responded to concerns and complaints and learnt from the issues raised.

• The registered and deputy managers worked professionally with agencies outside of the service and ensured a transparent, honest and open approach to their work which was valued by others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

Good (report published on 4 November 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The last inspection took place in February 2015. As a result of this inspection, we found the provider in breach of a regulation relating to safe care and treatment and asked them to submit an action plan on how they would address this breach. An action plan was submitted by the provider which identified the steps that would be taken. At this inspection, we found that the provider and registered manager had taken appropriate action and the regulation had been met.

Tenchley Manor Nursing Home is registered to provide accommodation and nursing care for up to 37 older people. At the time of our inspection, 29 people were living at the home. The home provides permanent placements and short-term breaks for older people with a variety of nursing and healthcare needs. Tenchley Manor Nursing Home is a large detached house situated on the coast at Selsey with views across the Solent towards the Isle of Wight. Communal areas include a large sitting room incorporating library and dining areas, a kitchen area where people and their relatives can help themselves to hot or cold drinks and a separate sun lounge. The majority of rooms have en-suite facilities. The home has extensive gardens to the rear of the property with access to the beach beyond.

A registered manager was 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 were provided with safe care and treatment. Risks to people were identified, assessed and managed appropriately. There were sufficient numbers of staff on duty to keep people safe and meet their needs. The registered manager was in the process of recruiting new staff to fill staff vacancies and employed safe recruitment practices. Staff had been trained to recognise the signs of potential abuse and knew what action to take if they suspected abuse was taking place. Medicines were managed safely and administered by trained, registered nurses.

Staff were trained in a range of areas to care for people effectively. New staff followed the Care Certificate, a universally recognised qualification. Training was updated as needed and staff were encouraged to study for additional, external qualifications. Staff had regular supervision meetings with their line managers and attended team meetings. The requirements of legislation under the Mental Capacity Act 2005 were followed and staff had a good understanding of their responsibilities under this legislation and about Deprivation of Liberty Safeguards. People had sufficient to eat and drink and all spoke highly of the food on offer. Special diets were catered for and people were supported to maintain good health through access to a range of healthcare professionals and services. People’s rooms were personalised and tastefully decorated and furnished.

Staff knew people well and cared for them in a kind, caring and compassionate way. People were complimentary about the staff who looked after them. They were supported to express their views and to be involved in making decisions about their care. People were treated with dignity and respect and had the privacy they needed. At the end of their lives, people were supported to have a comfortable, dignified and pain-free death.

Care plans included detailed, comprehensive information about people, their personal histories, likes and dislikes and how they wished to be cared for. A programme of activities had been organised for people and people were also able to access the community, either through organised outings, with staff or relatives or independently. Complaints were managed in line with the provider’s policy.

People were involved in developing the service and relatives and residents’ meetings were organised at which people could feed back their views. People were positive about the care they received and of the management of the home. Staff felt supported by management and said the registered manager was approachable and listened to any issues they raised. High quality care was evident and relatives too spoke highly of the care provided at Tenchley Manor Nursing Home. A range of audits measured and monitored the quality of care delivered. Some care plans and personal details about people had not been kept in a confidential way. We raised our concerns with the provider and registered manager and action was taken promptly to address the issues raised and ensure that records were stored securely.