Tamar House Nursing Home

Some people living at the service were cared for in bed due to their health care needs. These people had been assessed as requiring pressure relieving mattresses to help ensure they did not develop pressure damage to their skin. Air filled pressure relieving mattresses were not always set correctly for the people using them. There was no process in place to ensure staff checked these regularly. This was put in place immediately by the manager.

The service did not have a permanent nurse who worked during the day. This post was being covered by agency staff. Whilst the agency staff were mostly consistent there was little continuity of practice regarding medicines management. The manager told us they had appointed a permanent nurse who was due to commence their post in December.

People told us they were happy with the care they received, and people said they felt safe living there. Comments from people included, "Staff always knock and pop in to see me when they are passing by, they always ask if I am ok," "The staff are funny, lots of great banter, they are very nice" and "Staff are quick at answering the bell."

People looked happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service.

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

People were supported by sufficient numbers of staff to meet their needs. New staff had completed an induction into their role. Staff were recruited safely in sufficient numbers to ensure people's needs were met. There was time for people to have social interaction and there was a designated activities staff member to assist people. Staff knew how to keep people safe from harm.

Staff received appropriate training and support to enable them to carry out their role safely, including

nutritional support and dementia care.

The environment was safe, with re-carpeting and re-decoration ongoing. People had access to equipment where needed.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

Records of people's care were individualised and reflected each person's needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People's communication needs were identified.

People were involved in make meal choice and staff encouraged them to eat a well-balanced diet. The kitchen was due for upgrading but all equipment was in working order and the cook was able to provide freshly cooked meals from scratch for people. The cook was aware of people's specific dietary requirements. Comments included, "I like the food," "Plenty to eat and drink," "Good food" and "Sunday dinner is very good, and we get that twice a week." We heard on staff member offering many options to one person who had changed their mind about what they wanted to eat for lunch.

Records were accessible and up to date. The management and staff knew people well and worked together to help ensure people received a good service.

Staff told us the manager and the provider of the service were available and assisted them daily. They went onto say how they were approachable and listened when any concerns or ideas were raised. Staff comments included, "(Provider's name and manager's name) are really good." "I would be really happy for a loved one of mine to be cared for here" and "One of the best homes I have worked in."

People and their families were provided with information about how to make a complaint and details of the complaint's procedure were displayed at the service.