Our findings from Tower Bridge Care Centre - Summary report

Report summary

Level of care

Most residents we spoke to were positive about the nursing home, and most visitors were confident in the care provided. Most people said that staff were generally helpful and caring, and some individuals were highly praised. Staff we spoke to cared about their work and the residents. They reported taking part in a broad range of training and generally expressed confidence in current leadership, saying they felt able to raise any concerns.

Resources

However, several visitors mentioned varying quality of staff and of management oversight, combined with issues of low pay and stretched staffing, and a resident said they would like to chat more. We received mixed responses from staff about staffing levels and the time they have available to spend with residents. This is felt to be an issue across the care sector. The home has said they will review volunteering with a view to extending it.

Level of training

Staff told us that most training was done online and several mentioned a need for more dementia training. Some challenging behaviour impacting on other residents was observed in a dementia unit. Staff also referred to residents fighting. A family raised concerns that manual handling equipment was not used properly. The responses to this report outline the staff training currently in place. We have since discussed with commissioners the changes in support to nursing homes (for example through the Care Home Intervention Team (CHIT)) as well as reviews of some clients' needs.

Maintenance

We observed the home's physical environment to be mainly safe, pleasantly decorated and clean. Efforts had been made to provide appropriate points of interest such as historical pictures, an internal garden and a hat stand. However, we noticed occasional less dementia-friendly elements, and items in disrepair, which the home tell us they have now addressed. We were also unsure of the security of the building - the home has moved the sign-in book in response to this.

Rodents

Healthwatch Southwark had been alerted to rodents at the home (and associated hygiene issues) prior to our visits. During our visits we saw signs of recent mouse activity, and a visitor said they had recently seen live mice. We saw that bins in the bin yard were overflowing. Since the visit, the Council has visited the home several more times and is now reassured that the rodent problem has been successfully resolved and hygiene is acceptable.

Activities

We were told of some positive activities for residents, including outings assisted by volunteers for some people. The second floor was cheerfully decorated with Christmas decorations made by the residents. However, visitors' and residents' comments on activity levels were variable (some people said they were never able to go out), and some staff also wanted to be able to offer more activities.

Food

Food was generally praised and was served in balanced, adequate portions. Staff were observed helping and reminding residents to eat. However, the menus we observed were traditional British food and one person said they wanted more culturally appropriate food.

Safety

We did not see any visible signage identifying staff or managers in charge to residents and visitors. Some staff and volunteers were not wearing name badges or uniforms. The home tells us that information about the manager was already on display and information on other staff will be added; new badges have been ordered.

We saw no safeguarding, complaints or whistleblowing information displayed in the home – we are told that this is in residents' individual information packs. Dissatisfaction was expressed by some families about responses to specific concerns. The home has outlined feedback measures already in place.

We hope that our visits will have provided an additional opportunity for residents' and carers' opinions to be heard anonymously and openly, and that the home will find the detailed report useful as it works towards a shared goal of providing excellent care.

Healthwatch Southwark sincerely thanks the commissioners, service provider and staff, residents and families for making us welcome, and for their time, contributions and responses.

We could not undertake Enter and View visits without the support of our volunteers and we are very grateful for their time and skills.