Tennyson Wharf

Updated 2 March 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

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

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with ten members of staff including the registered manager, deputy manager, and support workers. We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 2 March 2021

About the service

Tennyson Wharf is a residential care home providing personal and nursing care to 23 people aged 65 and over at the time of the inspection. The service can support up to 60 people in five separate wings, each of which has separated adapted facilities. One of the wings specialises in providing care to people living with dementia. The provider had submitted an application to cancel their registration for nursing and was not providing nursing care at the time of the inspection.

People’s experience of using this service and what we found

The service had experienced a high turnover of managers since our last inspection. Staff told us this had an impact on consistency and had affected the morale of the team. Most staff we spoke with told us they did not feel supported by the registered manager. Staff told us they did not always feel listened to and valued.

Most relatives told us that communication from the registered manager was insufficient and had caused them anxiety during the recent outbreak of COVID-19 in the service. We raised these issues with the provider who took immediate steps to address these concerns.

The provider used a staffing calculator to calculate staffing levels according to people's needs and this had been recently reviewed. Staff and relatives, we spoke with consistently told us they were concerned low staff levels were having an impact on the quality of care people received. We discussed this with senior managers who assured us staffing levels would be kept under constant review.

Systems and processes were in place to manage risks associated with people's care. Risk assessments were in place to reduce risks associated with choking, falls and skin breakdown.

People were protected from abuse. Staff received training in safeguarding and were able to tell us how to recognise abuse and how to report it.

Records relating to the administration of ‘as needed’ medicines were not always consistent. We raised this with the registered manager who made immediate changes following the inspection to rectify this. Staff were observed following good practice when administering people's medicines. An effective medicines error reporting form had been implemented to enhance monitoring of errors and ensure lessons were learned to improve practice.

The service was visibly clean, and staff were observed following cleaning schedules. Regular enhanced cleaning of high touch points was recorded. Staff were observed using personal protective equipment (PPE) in line with government guidance. Staff had received training about infection prevention and control. We were assured the provider was preventing visitors from catching and spreading infections. The providers policies and procedures reflected the latest national guidance in relation to COVID-19.

A system was in place to record accidents and incidents and staff described how they used this. Some recording discrepancies were identified where falls were not always recorded on people's falls logs. We raised this with the registered manager who provided us with assurance this had been addressed immediately following the inspection.

The provider had a system to ensure the quality and safety of the service were reviewed on a regular basis. Senior managers had access to the audit reports throughout the pandemic and had clear oversight of the actions and progress of the service.

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

Rating at last inspection

The last rating for this service was Good (Published 28 January 2020).

Why we inspected

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

In addition, the CQC received a notification of a specific incident. Following which a person using the service sustained a serious injury. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of falls from moving and handling equipment. This inspection examined those risks.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern.

Please see the safe and well-led sections of this report.