Tremanse House Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified a breach of the legal regulations in relation to governance. Processes to follow up on concerns and arrangements to mitigate risk and oversee staff performance had not been completed in a timely manner. However, the registered manager had effective oversight of the service. Staff told us they were well supported and had a shared set of values focused on supporting people to develop skills and maintain their independence.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff had not always acted in a way which reflected the values of the organisation. In the main people were supported to be independent and their personal space and property was respected. We were told of incidents when this had not been the case and of an occasion when professional boundaries had not been adhered to.

When staff acted in a way which did not reflect the values of the organisation action to address this had not been taken in a timely manner. Performance management processes and protective measures were put in place to manage ongoing risk following the site visit. However, there were no clear plans detailing how long these restrictions would be needed or how they would be reviewed. The delay to introducing these protective measures meant there was a period of time when known risk had not been mitigated.

Staff told us the registered and deputy managers were supportive and always available for advice and support. When things went wrong they were able to reflect and learn from the experience

Systems to follow through on safeguarding concerns had not been effective, for example, a disciplinary process had taken a prolonged length of time to complete. When people had been distressed by leadership decisions they had not been effectively supported to express their views formally and appropriate mitigation to help people manage associated anxiety had not been provided.

Staff told us they were able to share their ideas and suggestions for the service at staff meetings and in supervision sessions. They were able to ask questions at any time if they were not sure of anything. They told us there was a culture of support rather than blame.

There were policies in place in relation to safeguarding and whistleblowing. Staff were aware of how to whistle blow if they felt they needed to. However, as outlined above safeguarding processes had not been followed.

All staff we spoke with, apart from 1, said there were good relationships between the registered and deputy managers and staff. One member of staff felt they had not had the guidance they needed to develop their skills. A member of staff told us, if managers were not on shift at the weekend, one of them would always contact the service to check everything was running to plan. Most staff told us they felt respected and valued. There were opportunities for development and career progression.

Staff told us there were effective processes in place to help ensure their voices were heard. Staff meetings and handover meetings were held regularly.

Staff told us there was a clear hierarchy of responsibility in place which they knew and understood. The registered manager received peer support from a registered manager based in another of the provider’s care homes. The registered manager was aware of potential impact on the morale of the house when new people moved in. They arranged for people to spend time at the service first to help ensure people’s needs could be met.

Audits were scheduled to take place throughout the year and roles and responsibilities for the audits were clearly laid out. Some of the reports generated by audits required more detail to help ensure they prioritised where actions should be taken. For example, as outlined in safe, a monthly managers report had identified where areas of the service required updating but had not classified areas for improvement in any order of importance or highlighted potential risk. Incident audits did not always highlight which staff had been involved in an incident meaning patterns might be overlooked.

People regularly accessed the local community. The service worked closely with the local GP and frailty team. A relative commented; “He likes walking and he walks to a local supermarket every morning to get a newspaper. The locals know him. They’ve (the staff) contacted the places that he goes to so they know him. He clears the tables and they give him a drink.”

The registered manager told us they worked closely with other agencies and professionals to help provide a joined up approach to care and support.

External professionals told us they worked well with the registered manager and staff at Tremanse. One commented; “The weekly call we have offers good communication for us and the home to keep abreast of on-going concerns and to manage long-term conditions well between both parties.”

Records showed the service had worked with external professionals to help ensure people received joined up care.

People were supported by staff who were keen to expand their knowledge and skills. One person told us they had been encouraged to complete additional training in order to become a senior. Staff meetings were held which were an opportunity to discuss any learning from incidents.

Incidents and accidents were recorded, analysed and reviewed monthly so any themes or trends could be identified. Action following concerns raised had not always been taken in a timely manner.