Tunbridge Wells Care Centre is registered to provide accommodation, personal and nursing care for up to 70 people including those living with dementia. Accommodation is located over three floors. There were 62 older people including some living with dementia accommodated in the home when we inspected.

We carried out this unannounced inspection of the home on 2 November 2016.

At the time of our inspection there was a registered manager in place. They had been registered since January 2015. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were kept safe and staff were knowledgeable about reporting any incident of harm. People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service.

People were supported to take their medicines as prescribed.

People were supported to eat and drink sufficient amounts of food and drink. They were provided with choices of food and drink to meet their individual dietary preferences and requirements. People were helped to access health care services. This was to ensure that their individual health needs were met.

The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA 2005] and the Deprivation of Liberty Safeguards [DoLS] and to report on what we find. The provider was aware of what they were required to do should any person lack mental capacity. People's mental capacity was assessed and people were able to make decisions about their day-to-day care. Staff were knowledgeable about the application of the MCA.

People were looked after by staff who were trained and supported to do their job. The registered manager ensured that people received individual supervision that supported them to undertake their roles.

People were looked after by kind staff who treated them with respect and dignity. They and their relatives were given opportunities to be involved in the setting up and review of people's individual care plans.

There was a warm and welcoming atmosphere in the home and staff worked closely with people and their families. This was to ensure each person was supported to maintain their individual interests and to have a meaningful and enjoyable life. In addition, staff provided a varied programme of communal activities for those who wished to participate in them.

Care was provided based on people's individual needs and helped to reduce the risk of social isolation. There was a process in place so that people's concerns and complaints were listened to and action was taken to address them.

The registered manager was supported by a team of management staff, ancillary staff and a team of nursing and care staff. Staff were supported to look after people in a safe way. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action was taken where improvements were identified.

We spoke with ten people who use the service or their relatives. The interactions we observed between staff and people using the service were friendly and respectful. One of the people we spoke with said they had a say in how their care was provided. They said “it’s good” and “I wouldn’t change anything”. People had personalised their rooms, and there were open visiting hours. There was an activity programme available, and people received a weekly summary of this.

People had their capacity to make decisions about their care assessed. They were offered choices, and where they had the capacity made decisions about their care. Where they were unable to consent, relatives were involved in making choices for them.

The people we spoke with and their relatives were positive about the service and the care provided. One person told us “the care’s excellent” and “I can’t fault anything”; another said that it was “reasonably good”. A relative told us that the home were good at communicating, and told them what had happened with their relative. They said they were very happy with the care provided, and thought that their relatives care needs had been met.

There were safeguarding processes in place.

Staff received the necessary training and appraisal and to support them to meet people’s needs.

We spoke with seven people who used the service and five relatives. They were positive about the service. One person told us the staff were “very good and loyal”, another said that there were “little moans and groans” but they thought it was “all good.” One person told us it’s "very pleasant” and "if you want anything, they get it for you."

All but one of the people we spoke with were complimentary about the food saying it was “super” and they “get all they need”.

The people we spoke with were positive about the staff and the care they provided. One person said “the carers are wonderful” and “there were a “few blips, but the girls are good.” Another person said there had been a lot of agency staff “but they are all very good” and “there’s nothing you can blame them for.” A relative told us “all the staff were wonderful, right up to the cleaners.” However, not all staff had completed what the service set out as its minimum training requirements.

People told us they were asked for their opinions about the service, and that the manager asked them if there were any problems.

The service had processes in place for safely administering people’s medication.

One person told us they felt able to complain if they needed to, and a relative told us that they felt able to say anything to the staff as “they seem to be on your side.” The relatives we spoke with confirmed that the manager and her deputy were approachable and available.

It was not possible to interview many people as some were too poorly and others with dementia were not able to engage with the process. We were able to talk briefly with a relative and one person who lives in the home.

People said they enjoyed the food. They told us they felt safe and knew who to talk to if they were unhappy. They also said, “Everywhere is always nice and clean.” One person told us they had been fully involved in the process of assessing their needs before moving to the Care Centre. They told us the manager had visited them at their home. They had also seen helpful information and been able to visit the service. Another person said staff were very good and took care of them well.

It was not possible to talk to many people as some were too unwell and others with dementia were not able to engage with the process. We were able to spend time with a number of people who live in the home. We found people were calm and relaxed. They were comfortable chatting with staff and the manager. They told us staff looked after them well and they were happy living in the home.