Inspection on 16/04/07 for Tudor House Residential Home

This inspection was carried out on 16th April 2007.

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 Residential Home 03/08/06

Tudor House Residential Home 12/12/05

Tudor House Residential Home 01/12/04

Tudor House Residential Home 07/09/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Tudor House Residential Home Tudor House 6 Park Crescent West Park Wolverhampton West Midlands WV1 4PY Lead Inspector Mr Ian Harris Key Unannounced Inspection 16th April 2007 08:00 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 Residential Home DS0000029962.V335747.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 Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tudor House Residential Home Address Tudor House 6 Park Crescent West Park Wolverhampton West Midlands WV1 4PY 01902 429008 01902 832709 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) Mrs Aurora McGarrigle Juliet Courine Douglas Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (9) of places Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Maximum number of residents - 9 persons (OP) category, females over 60 years and males over 65 years of age. 3rd August 2006 Date of last inspection Brief Description of the Service: Tudor House is a nine-bedded care home currently registered for older people. The home is a three storey Victorian building with parking facilities to the front of the building and a small paved patio to the rear. It is located near the centre of Wolverhampton, close to shops, West park and bus routes. The three-storey building currently has a lounge, dining room, kitchen, two toilets, two bedrooms and a bathroom on the ground floor, with the remaining bedrooms on the first floor along with a toilet and bathroom. The second floor has a small flat that is now being used as office space. Tudor House make their services known to prospective service users in: the Statement of Purpose and service user guide. The inspection report is mentioned in these documents and is available in the home. Tudor House’s rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for hairdressing, newspapers and private chiropody appointments. This is clearly laid out in the terms and conditions. Fees for care as of 1st April 2007 are: £323 per week. All service users pay monthly by standing order or by cheque. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection and took place over 4 hours. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 3 members of staff and 5 residents were spoken with. Six case files were selected for case tracking, relevant documents were inspected and discussions were held with residents, and members of staff. Observation was made of the various daily activities. On the day of inspection the atmosphere within is comfortable with contented residents. All the residents spoken with who could express themselves in a meaningful way expressed their satisfaction with the care they received and there were comments as follows “ the food is good here” “The staff are very good” “ this is a very nice home.” “We are one big happy family here”. What the service does well: The atmosphere within the home is comfortable and friendly. The friendly rapport was also observed between residents and staff. Meals are varied, well balanced and presented to meet each individual’s choices, preferences and requirements. There is friendly communications with families/friends and representatives of the residents. The residents spoken with said that they are happy and content with living in a homely and caring place. Residents spoken with stated that the home is a very happy place to live and the day-to-day dealing with the manager is very good. The home has a good staff- training programme, which all staff are involved in, this ensures that they are improving their knowledge and skills to meet the changing needs of the residents. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Tudor House Residential Home DS0000029962.V335747.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 Residential Home DS0000029962.V335747.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 The quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. . Standard 6 could not be looked at because The Elms does not provide an intermediate care service. The home has a good admissions procedure ensuring the individual needs of the residents are fully met. EVIDENCE: The statement of purpose and service user guide, detail the assessment process and a copy is place in every residents bedroom. Six case files were selected for inspection and included files of people recently moving into the home. There is evidence on the files that all the residents who are funded by the Local Authority undergo a full multi-disciplinary assessment prior to admission. The residents, who are self funding are assessed by the Care Manager, using the home’s assessment forms. Pre admission details were included in the other files together a record of trial visits to the home, details of assessed care needs and an environmental pre Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 9 admission audit. Residents’ spoken with said they had opportunity to visit the home before moving in and also had access to written information. Tudor House Residential Home DS0000029962.V335747.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 The quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. Each resident has an individual care plan, which are written in plain language, are easy to understand and are reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration of medication are good with clear and comprehensive recording arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident, which is written in plain language, easy to understand and based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a monthly basis. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 11 The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that, these services are provided by local practitioners. The records indicate that resident’s medical needs are being met and this was confirmed by two resident’s. Medication is administered by means of a monitored dosage system. The system appears to be working very well. This ensures that medications are handled safely and residents get the medications they have been prescribed. The home receives good support from the local pharmacist who does a three monthly audit of the homes medication. All care Staff have been trained to use the system before they are allowed to administer medication. Particular attention is given to ensuring privacy and dignity when delivering personal care. Observation of the working practices of three carers throughout their morning shift confirmed they were courteous and attentive to the individual needs of the people living at the home. All of the residents seen were well groomed and attired. No personal care interventions take place in communal areas. Observed practice on the day of inspection was appropriate and showed respect for the residents. Three of the residents’ who could express themselves in a meaning full way said that the staff were very helpful and kind “ We are one big happy family.” Tudor House Residential Home DS0000029962.V335747.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The Quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. The home provides a programme of social activities within the home, which is designed to meet the resident’s capabilities, which the staff encourage residents’ to pursue. The Care Manager and staff encourage family and friends to maintain good contact with their relatives at the home. The meals in the home are good offering both choice and variety, also catering for special dietary needs. EVIDENCE: The Home works hard to involve residents in a range of leisure opportunities, The activities which are provided places an emphasis on more meaningful pastimes tailored to individual needs. A weekly activity log is completed for each individual. A designated staff member ensures there are a variety of things for residents to do as a group or on their own. It was noted that the people who currently live at the home have enjoyed craft sessions, musical evenings, reminiscence groups, keep fit exercises and sing a-longs. Details are displayed in the foyer and include community outings as well as visiting entertainers. Photographs are taken of events and shared with service Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 13 users and visitors. Religious observance is assisted. Service users spoken with stated that they may receive visitors at any reasonable time of the day and that they are always made very welcome by the staff. The manager and staff at the home encourage regular contact between residents’ and their relatives by inviting them to parties, fetes, outings and celebrations. All residents’ comments were very complimentary about the standard and choice of food provided. It was noted that the menu for the main meal of the day is changed to incorporate seasonal variations. Several residents’ told the Inspector that the food was nice, tasty and well prepared. The kitchen is well equipped, kept clean and tidy. The catering staff are trained in food safety and hygiene matters. Tudor House Residential Home DS0000029962.V335747.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, and 17 The quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. Residents and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse EVIDENCE: The home has a good comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence, the service users guide, of which a copy is placed in every bedroom and on the notice board in the reception hall. A number of residents stated if they had any problems the Manager would sort it out for them. Residents’ were seen to speak easily to staff and were comfortable in their company. Staff were seen to be skilled in communicating with elderly persons to ascertain their well-being. The home has a complaints book in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection and all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. Multi-agency policies are available so that staff are aware of procedures to follow in case of any allegation or suspicion of abuse. These Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 15 issues are also covered in the homes induction training, external and N.V.Q. training, which all care staff have undergone. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing the residents with a very attractive, comfortable, homely and safe place to live. The residents live in an environment that was found to be clean tidy and free of unpleasant odour. The rear garden needs improvements following the provision of new fencing to provide the residents with a pleasant out door facility. . EVIDENCE: The home is long established and has been adapted in order to provide appropriate accommodation for older people. The home is maintained to a good standard, and provides a very comfortable homely and safe place for the residents. Communal areas were clean and comfortable. The residents bedrooms have been personalised with the residents’ own personal Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 17 possessions. This gives the appearance of a very comfortable environment. Service users commented that they were very pleased with the attention given to making the place comfortable and homely. There has been some work carried out in the home since the last inspection, which includes the redecoration and refurbishment of two bedrooms, the renewal of the rear garden fencing and the provision of a new washing machine. However it was noted work should to be carried out in the rear garden to restore it following the erection of the new fencing. There are some broken tiles in the ground floor bathroom that need replacing. The home is in compliance with the Fire Safety Officer’s requirements. During the inspection, the home was found to be clean, tidy and free from any unpleasant odour. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. These staff are recruited and trained properly and this helps to ensure that residents are safe and well cared for. EVIDENCE: The inspection of staff rotas and discussions with staff and residents indicated that the home is well staffed. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. It was noted that there have been minimal staff changes since the last inspection. Discussions with six residents in a group confirmed they thought the staff are respectful and helpful. Observations of staff carrying out a variety of tasks appeared to confirm they are clear regarding their role and what is expected of them. The files of six members of staff was seen which showed that recruitment checks are being carried out there was evidence that all Criminal Record checks are being carried out. Evidence of induction and initial mandatory training was seen. Staff confirmed that training is provided and there are many opportunities to improve themselves for the benefit of service user care. All staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 19 activities. The home has a programme of N.V.Q. training that has exceeded the minimum standard. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 The quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by a competent registered manager, where service users interests and welfare is promoted. The home has good policies and procedures regarding Health and safety and meets the requirements of the Fire Officer and Environmental Health Officer, promoting a safe environment for the residents. EVIDENCE: The Care Manager has the Registered Manager’s Award and considerable experience in caring for older people. There are clear lines of accountability within the home and the manager is very supportive of both staff and residents. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 21 Observations made and discussions with residents’ and staff indicated that the Care Manager is very approachable and operates an open door policy. The staff and residents who could express themselves stated that they are happy to approach the Care Manager and staff with any problems they might have and were confident that they would be responded to. There is a good staff supervision system in place and there is evidence that the staff have regular supervision meetings. It was also noted that the home has a Quality Assurance system in place, which includes questionnaires to residents, visitors, other professionals and relatives to obtain feedback on the quality of service. The feedback from the last issue was very positive regarding the care they are receiving. However an action plan should be produced to address issues raised by the feedback. All the Financial records and administrative procedures within the home that were inspected were found to be well ordered and maintained. The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues and a number of staff have received training on these issues. All recommendations and requirements made at the last inspections of the Fire Prevention Officer and Environmental Health Officer have been actioned. Records indicated that all safety equipment is regularly checked and well maintained. Tudor House Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 22 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 X X 3 X X 3 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 X 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 Residential Home DS0000029962.V335747.R01.S.doc Version 5.2 Page 23 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. 1 2 3 Refer to Standard OP19 OP19 OP33 Good Practice Recommendations The registered person should ensure that the rear garden is restored to provide the residents with a pleasant usable garden amenity. The registered person should ensure the tiles are repaired in the ground floor bathroom to improve the residents’ environment. The registered person should develop an action plan from the quality assurance findings in order to respond to residents/ relatives’ comments. 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