We carried out a review of the data available to us about Tonbridge House Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Tonbridge House Care Home, you can give feedback on this service.
We found the following examples of good practice.
People were well supported by staff to have telephone and internet contact with their family and friends. The service facilitated in person visits in a manner which minimised the risk of infection spread, including outside visits, window visits and visits using patio doors in ground floor rooms.
Plans were in place to isolate people with COVID-19 to minimise transmission. The service had good supplies of personal protective equipment (PPE) that were readily available in stations throughout the service. Staff were seen to use PPE appropriately and the use of PPE was regularly audited by the registered manager and home trainer.
Visitors were asked screening questions, had temperature checks and were supported to wash and sanitise their hands when they arrived. Lateral flow tests were carried out on arrival and visitors were only permitted into the home once a negative test was confirmed.
Staff had received training on how to keep people safe during the COVID-19 pandemic, staff and residents were regularly tested for COVID-19. The building was clean and free from clutter, there were schedules in place for regular cleaning of high touch areas.
Staff ensured people’s welfare had been maintained and they had sufficient stimulation, such as staff supported activities. This included activities such as a regular prayer group for people interested in participating that was facilitated by a member of the care staff.
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.
This is the first time the home has been inspected since it registered on 29 May 2018. There was 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 and relatives told us they had no concerns with their safety and could speak to the registered manager if they did. Safeguarding and whistleblowing policies were in place and the provider had notified us of any concerns. Risks to people were assessed on an individual basis and there was comprehensive guidance for staff. There were enough suitably trained and safely recruited staff to meet people’s needs. The registered manager had ensured the environment was safe and staff understood how to prevent and control infection. The property was well maintained and cleaned to a high standard. The registered manager had an overview of accidents and incidents, had analysed these through their electronic system and learnt from these.
Medicines, including those ‘as required’ were ordered and given safely through an electronic system. Medication was stored safely, stock levels were managed and discarded medication was disposed of appropriately. There was one incident of a liquid medication where an incorrect expiry date had been recorded and it had been given after it should have been discarded. We spoke to the registered manager about this who took immediate corrective action and the pharmacy advised there would be no adverse effect to the person.
People had assessments which were person centred, included all their needs and their rights to equality. The provider ensured managers, nurses and care staff had the right induction, training and on-going support to do their job. People were supported to eat and drink enough to maintain a balanced diet. People had the involvement of a dietician and there was information in the kitchen regarding people’s dietary needs. Feedback on the food was very positive and we observed people were enjoying the mealtime experience. People were offered choice and were encouraged to have as much as they wanted to eat and drink.
People accessed the healthcare they needed and the provider worked closely with other health professionals to ensure people were supported with various health conditions. People’s needs were met by accessible facilities and the environment had been tailored to maintain the independence and dignity of people with dementia. 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.
Staff knew people well and interacted with people in a caring and respectful manner. Medication was administered kindly and nurses offered people any explanations they required. People were involved in their day to day care and developing their care plans as much as possible where they wished to. People’s rights to a family life were respected. Relatives told us they could visit whenever they wanted and were made to feel welcome. Some relatives visited every day. Peoples’ privacy and dignity was respected by staff and people’s independence was promoted.
People’s care plans were person centred, had been reviewed regularly and updated when people’s needs changed or more information was learnt about the person. Some care plans were work in progress as the home was new and people had only been there for a few months, a few weeks or days. People were receiving care which met their individual needs and effective outcomes were achieved from assessments. People’s care plans included a section on communication to detail their individual needs. People were supported to take part in activities they liked within and outside of the home.
People and relatives could raise any concerns or complaints they had and told us who they would talk to. The complaints procedure was available and the provider actively sought feedback from people and their relatives. Complaints were recorded, monitored and managed appropriately. There was an advanced care plan in place for one person described as end of life.
Relatives told us they thought the home was well managed. The management team consisted of the registered manager, the residential care manager, the deputy manager, the client services manager, nurses and team leaders. The registered manager and provider promoted a positive, person centred and professional culture, had good oversight of the quality and safety of the home, and risks were clearly understood and managed. The provider supported good governance through using a system which alerted the registered manager to any incidents. Internal audits were completed, used to check compliance and produce action plans. Record keeping was good and was made easily accessible for staff. The registered manager demonstrated continuous learning by reviewing audit action plans, complaints, promoting feedback and analysing accidents and incidents. Action was taken where needed as a result of the analysis.
Staff told us they were supported by the management team and were encouraged to complete further training. Good communication and staff engagement was promoted. Surveys had been done with staff and were being developed for people and relatives. Meetings were held and the management team were receptive to feedback. The management team worked in partnership with other agencies and engaged with their local community.