Tamara House

Updated 3 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 17 January 2022 and was announced. We gave the service two days’ notice of the inspection.

Updated 3 February 2022

About the service

Tamara House is a residential care home that provides care and accommodation for up to 29 older people, some of whom are living with dementia. At the time of the inspection there were 24 people living in the service.

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

We had received information of concern that there were not always sufficient staff on duty on every shift. The service had been suffering from the challenges being felt across the sector, with difficulty recruiting new staff. We found there had been shifts when there had been only two staff on duty due to short notice sickness absence. The provider assured us, and staff confirmed, that during such occurrences a third staff member was bought in to support the shift as soon as possible.

Staff told us, “I like working here. Yes, there have been difficult times and still is with staffing but we sort of support each other," "It's OK but we are really short staff sometimes" and “It has been disruptive when the previous manager left. I hope the new manager is a good one.”

There had been many changes to the management team, with the manager leaving recently, then the acting manager leaving a few days after this inspection. There was no registered manger in post at the time of this inspection. The provider advised us that a new manager was due to join the service in February 2022. The administrator was providing some oversight of the service during this period and was present in the service during the week.

The providers and registered manager of a sister home had all been abroad on holiday together prior to this inspection. They were awaiting confirmation of negative PCR tests and were unable to physically attend the service to provide support. We spoke with them throughout this inspection via a video conference.

People told us they were happy with the care they received and believed the service was safe. Comments included, "Yes they come whenever I need them and they pop in to check I'm OK" and "I wasn’t looking forward coming into a care home, but I needn't have worried. All the staff are so kind and helpful. Nothing is too much trouble."

Risks were identified and staff had guidance to help them support people to reduce the risk of avoidable harm.

There were clear records to show, when assessed as needed, staff were monitoring specific health needs such as people’s weight, nutrition and hydration and skin care. Any changes in people’s health were escalated to the relevant professional and relatives were kept informed.

The electronic medicines system supported staff to manage medicines administration safely. Staff received suitable training. People received their medicines on time.

We had received concerns that some areas of the service were not clean. At this inspection we found the premises were clean and well maintained.

We received concerns that people were not always given a choice about when they got up or went to bed. We checked this with some people and staff. Staff comments included, “Nobody gets up or goes to bed if they don’t want to. I know we are short staffed at times, but it really is run for the residents. Some like to get up earlier and go to bed earlier but it’s their choice.” and “There are a few residents who like to get up around 6am. A few regulars that like to go up around 6pm to their rooms. Staffing levels have not decreased choice in this respect.”

People had access to equipment where needed. However, one person was awaiting a specialised hoist to support them. Pictorial signage was in place to help orientate people living with dementia to areas of the service. Red meal plates were also in use to support people’s independence at meal times.

Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. However, at the time of this inspection there was no cleaner on duty at the weekends. Staffing levels at weekends had been low and so staff did not always have time to ensure all high contact points and communal areas were cleaned in line with COVID-19 guidance. The provider assured us this would be addressed immediately.

Visiting was taking place in line with current government guidance.

People, their relatives and staff had not been asked for feedback on the service’s performance since our last inspection in March 2021. We were assured this was planned in the near future. There was a stable staff team who knew people well and worked together to help ensure people received a good service.

People and staff told us the management team were approachable and listened when any concerns or ideas were raised.

Staff worked well with external healthcare professionals such as GP’s and district nurses.

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

Rating at last inspection and update

The last rating for this service was overall good. (Report published 11 November 2021). An inspection was carried out in March 2020 looking just at the key question of safe only and this inspection was not rated. At this inspection the rating for this service remains the same.

Why we inspected

We received concerns in relation to the management of the service, the quality of care provided and the cleanliness and safety of the environment. As a result, we carried out a focused inspection to review the key questions of safe and well-led only.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Tamara House on our website at www.cqc.org.uk.

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.