Inspection on 26/07/06 for Tudor House

This inspection was carried out on 26th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tudor House 12/12/05

Tudor House 30/09/05

Tudor House 10/12/04

Tudor House 06/08/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Tudor House 79 Victoria Drive Bognor Regis West Sussex PO21 2TB Lead Inspector Ms J Hartley Key Unannounced Inspection 26th July 2006 12:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tudor House Address 79 Victoria Drive Bognor Regis West Sussex PO21 2TB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 823406 Mr Marimuthu Subramaniam Mrs Brenda Swee Chin Subramaniam Mrs Brenda Swee Chin Subramaniam Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24) Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2005 Brief Description of the Service: Tudor House is a care home providing personal care and accommodation for twenty-four older people over the age of sixty-five who have dementia. It is privately owned by Mr & Mrs Subramaniam. Mrs Brenda Subramaniam is the registered manager. The home is situated in a residential area of Bognor Regis, West Sussex and is a short distance from the town. The property is an extended detached house with accommodation arranged on two floors both of which are served by a passenger lift. The home has a combination of single and double rooms with seven of the single bedrooms having en-suite facilities. There is an enclosed rear garden and large front garden both of which are accessible to service users and very well kept. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over a period of three and a half hours. The inspector examined information held on the service file since the last inspection in December 2005, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose. The home also returned a pre-inspection questionnaire. Information from this is also included in this report. During the inspection the inspector spoke to two members of staff, four visitors and three residents. The inspector was unable obtain the views of some of the residents due to the level of their dementia. The inspector undertook a tour of the premises and looked at three care plans and three staff files. Various record books, policies and procedures were also examined. The current charge is £389 per week. What the service does well: What has improved since the last inspection? Since the last inspection a bedroom and one communal area have been redecorated. Chairs in the lounge have been reupholstered. A window restrictor that was found broken at the last inspection has been fixed. The home is now asking for a full employment history as part of its’ recruitment process. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6 Tudor House has a Statement of Purpose and Service User Guide that contain information to enable service users to make an informed choice about where to live. Prospective residents have their needs assessed prior to moving into the home to ensure that the home is able to meet their needs. Tudor House does not provide intermediate care therefore Standard Six does not apply to this service. The outcome for residents is good. EVIDENCE: An up to date Statement of Purpose and Service Users’ Guide were seen prior to the site visit. They contain the information required to enable service users to make an informed choice about the home. Evidence was seen that these documents have been reviewed regularly. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 9 Residents’ files seen on the day of the inspection included full assessments provided by the placing authority or undertaken by the registered manager. Each resident has a plan for daily living that sets out individual needs and long-term goals. Tudor House does not provide intermediate care. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 There are plans of care in place that reflect individual need and that are drawn up with the involvement of the service user wherever possible. Plans of care are reviewed monthly. The health of service users is promoted and maintained by the registered person. Service users have access to health services to meet their assessed needs. Medication policies are in place regarding the receipt, recording, storage, handling, administrations and disposal of medicines. These policies and procedures are adhered to by staff. Service users are able to take responsibility for their own medication if they wish, within a risk management framework. Residents are treated with resprect and their right to privacy is upheld. The outcome for residents is good. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 11 EVIDENCE: The inspector examined the records of three residents. Each contained a detailed care plan generated from the initial assessment, and reviewed on a monthly basis. Residents are encouraged to be involved in the drawing up of care plans and in reviews if they are able to. Records seen included pressure sore and falls risk assessments. Evidence was seen that residents have access to GP’s, opticians, dentists, chiropodist, district nurses and other healthcare professionals as required to meet their health needs. Medication records seen were up-to-date and correctly recorded. The home has a procedure for the receipt, recording, storage, handling, administration and disposal of medicines. There are no controlled drugs being administered at the home at present. The medication cabinet was seen to be in good order with no over-stocking of medication. The home’s medication procedures are inspected by Boots pharmacy on a regular basis. Reviews and changes to medication were seen to be clearly recorded in individual service users’ files. Due to the needs of the service users at Tudor House, no one is currently selfmedicating. However a risk management framework is in place so any future residents who wish to self-medicate would be able to following an assessment. Staff are only allowed to administer medication after training and an assessment by the registered manager. During the inspection staff were witnessed treating residents with respect, dignity and kindness. Staff were seen encouraging residents to perform tasks themselves, e.g. one lady was assisted in using a spoon to feed herself, and another was encouraged to take off her own cardigan rather than staff doing it for her. Screening is provided in shared rooms to protect privacy and maintain dignity. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Residents find that the lifestyle they experience in the home matches their expectations and meets their needs. They are supported in maintaining contacts with family, friends and the local community. Residents are able to exercise choice and control over their lives. They enjoy the food provided at the home. Special diets, likes and dislikes are catered for. The outcome for residents is good. EVIDENCE: Residents are able to make choices in their lives, including what they are going to wear, what they eat for dinner and other meals, what activities they take part in, and personal religious observance. Residents’ interests are recorded in their individual care plans. Tudor House has a full and varied activities programme in place. The registered manager employs the services of an organisation that specialises in providing activities for people with dementia. Activities provided include; singing, word games, reminiscence, reality orientation, quizzes, ball games and bingo. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 13 The home has good links with local churches and is able to provide for the diversity of religious beliefs of the residents. Holy Communion is held once every three weeks at the home. Representatives from local Catholic, Methodist and Baptist churches visit the home regularly. Staff assist two residents in attending a local church. On the day of the inspection the inspector spoke to four visitors to the home. They said that they were made welcome when they visit and were able to see their relatives in the privacy of their own rooms or in communal areas. Mr. Subramaniam cooks all the main meals at the home. A record of food eaten is kept in the diary. On the day of the inspection the food provided looked nutritious and well presented. Residents who need it are provided with liquidised food. Staff were seen assisting residents in an unhurried and unobtrusive manner. Residents were seen to be enjoying their meal. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home has clear policies and procedures regarding complaints. Service users are protected from abuse, neglect and harm as far as possible by the home’s policies, procedures and staff training. The outcome for residents is good. EVIDENCE: The complaints book and procedures were inspected. The procedures were clear and included recommended timescales. The home’s procedures on abuse, Adult Protection and whistle blowing were seen. A recent anonymous complaint had been responded to promptly and appropriately by the home, including referring the issue to Adult Protection. All the details had been recorded thoroughly. Staff records show that staff have received training in Adult Protection. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25, 26 The environment at Tudor House is safe, comfortable and adequately maintained. The home is clean, pleasant and hygienic. The outcome for residents is adequate. EVIDENCE: Tudor House is a detached house in its own grounds situated close to the town centre of Bognor Regis and to the sea. The location and layout of the home is suitable for its stated purpose and is adequately maintained. Some areas are showing signs of wear and tear and will need to be redecorated soon. One bedroom and one communal room have been redecorated since the last inspection. Armchairs in the lounge have been re-upholstered. The grounds are tidy, safe and accessible to residents. A tour of the premises found Tudor House to be clean and free from offensive odours on the day of the inspection. The home has central heating. All radiators and pipe work are covered. Windows have restrictors fitted for Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 16 safety. The window restrictor that was found to be broken at the last inspection has been fixed. Emergency lighting is provided throughout the home. A Legionella test was done in April 2006. The home has policies and procedures in place regarding the control of infection. The laundry is sited away from food storage and preparation areas, has impermeable floor finishes and is easy to clean. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The numbers and skills mix of staff meet the needs of residents. Residents are as far as possible protected by the home’s recruitment policies and procedures. The outcome for residents is good. EVIDENCE: The number of staff on duty on the day of the inspection was appropriate for the size of the home and the needs of the residents. The rota for the home was seen. The home has four staff on duty in the mornings, three in the afternoon and two waking night staff. The home’s recruitment policies and procedures were found to be thorough. Criminal Records Bureau and Protection of Vulnerable Adults checks are carried out prior to employment. A full employment history is now being obtained prior to employing new staff. Staff records show that all new staff undertake induction training within six weeks of starting work. The induction programme meets the current guidelines. The home has a training programme in place for staff. Training available includes Health and Safety and courses relevant to the specific needs of the service users, including Communication and Dementia Care. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The registered manager is competent and qualified to manage the home. The home is run in the best interest of residents. Residents’ financial interests are safeguarded by the policies and procedures of the home. The health, safety and welfare of residents are promoted and protected. The outcome for residents is good. EVIDENCE: Mrs. Subramaniam’s qualifications and experience show her to be competent to run the home. She is a registered nurse and has recently completed the Level Four NVQ Registered Manager Award. Tudor House has a quality monitoring system in place. Once a year they send out questionnaires regarding the quality of care and the running of the home. The replies are then audited to enable the home to monitor its performance Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 19 and identify areas for improvement. The inspector has seen the results of the last survey. The manager acts as appointee for one service user. The manager keeps a record of all transactions, and ensures that monies are kept separate from that of the home. Relatives or solicitors handle the finances of the other service users due to their dementia. Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tudor House DS0000014807.V304195.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor, Overline House Blechynden Terrace Southampton Hamsphire SO40 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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