Inspection on 01/03/06 for Tudor Lodge

This inspection was carried out on 1st March 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 Lodge 03/12/08

Tudor Lodge 13/12/06

Tudor Lodge 22/08/05

Tudor Lodge 31/01/05

Tudor Lodge 10/08/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Tudor Lodge 8 Brightstowe Road Burnham-on-Sea Somerset TA8 2HW Lead Inspector Ms Rachel Fleet Unannounced Inspection 1st March 2006 09.15 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 Lodge DS0000015974.V276772.R01.S.doc Version 5.1 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 Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tudor Lodge Address 8 Brightstowe Road Burnham-on-Sea Somerset TA8 2HW 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) 01278 784277 01278 786844 judy@tudorlodge.net www.tudorlodge.net JDA Care Limited Mrs Judith Isabel Arnold Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd August 2005 Brief Description of the Service: Tudor Lodge is registered with the Commission for Social Care Inspection to provide personal care for up to 27 residents over the age of 65. Nursing care is not provided. The Home is owned by JDA Care Limited. One of the Directors Mrs Judy Arnold - is also the registered manager. In keeping with the properties around it, the home is a large older style building, in a residential area of Burnham-on-Sea. Various aids and adaptations have been fitted to enable service users to move freely around the home. There is a passenger lift and a chair lift providing access to different areas. All communal areas are on the ground floor. The home also provides day care for a small number of people from the local area. Such services are not regulated by CSCI. Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector Rachel Fleet was at the home for just over five hours. She met with nine of the 25 residents around the home, and spoke with three care staff, as well as Mrs Arnold and Chris Arnold, another of the directors who works at the home. She also looked at documentation, including care records for three residents. Standards that were met at the last inspection have not been re-inspected on this visit. The report from that inspection, carried out on 22 August 2005, should therefore be read along with this report, for fuller information. What the service does well: What has improved since the last inspection? Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 6 Refurbishment and redecoration of vacated bedrooms has taken place. During the inspection, a toilet near the day rooms was being raised, and the area retiled. New occasional tables have been bought, to replace some that had sharp corners – a problem raised by residents at a residents’ meeting. Recommendations made following the last inspection had been addressed: social care needs are included in individuals care plans; there were no issues regarding procedures for responding to allegations of abuse, thus promoting the safety and protection of residents; there was evidence of adequate arrangements for reviewing fire precautions; window restrictors are in place. 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 Lodge DS0000015974.V276772.R01.S.doc Version 5.1 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 Lodge DS0000015974.V276772.R01.S.doc Version 5.1 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): These core standards were met at the last inspection. EVIDENCE: Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 9 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&9 Residents’ care is very well planned, providing staff with good information as to how to meet residents’ needs. Residents’ wellbeing is protected by good medication procedures. EVIDENCE: Social care needs, as well as physical needs, were well documented in care plans - with community links (church attendance, etc.) included in residents’ notes. Care plans had been reviewed regularly, including after accidents had occurred, with evidence of resident involvement in drawing up initial care plans. Self-medicating residents had been given lockable facilities for safekeeping of medication. Others were satisfied with the home’s management of their medication. Medication reviews were evidenced. Medication records were well kept. Drug fridge temperatures - recorded daily – were in the appropriate range. However, daily minimum/maximum temperatures were not recorded, as is good practice when storing insulin. More than one staff was involved in recording medication received into the home. A staff training record showed six-monthly medication training/updates and observed practice. A comprehensive medication policy was kept on the medications trolley. Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 10 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): 14 Residents have good opportunities to have control over their own lives, through promotion of choice and respect for independence by the home. EVIDENCE: Residents felt generally there was sufficient choice offered, in their daily lives. Daily care notes showed that one resident wished to have their door locked overnight, and this was respected. Care plans included that some residents might prefer to be alone but should be offered the choice of joining their peers, for an activity for example. Risk assessments were recorded, some evidencing how residents were enabled to be as independent as possible whilst remaining as safe as possible. One resident who had a diabetic diet provided by the home said that, if she chose to, she could ask for an ordinary diet because of her right to make choices for herself. Three residents spoken with said they felt they went to bed too early sometimes, although one of these said this had been raised with the home and was being dealt with. Others said they went to bed when they wanted to, one saying she preferred to stay up late, being assisted to bed at about midnight. Staff spoken with were all clear that residents are offered help to go to bed during the evening and that some declined the offer, choosing to stay up, especially if a favourite programme was on TV, for example. Mrs Arnold said she would include the matter in the next ‘Quality of care’ survey the home carried out. Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 11 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): 18 Staff have appropriate attitudes and good knowledge, to help ensure residents will be protected from abuse. EVIDENCE: A resident with no visiting relatives had a solicitor acting for them. Residents who were asked said they felt safe at the home, and conversations with residents did not give rise to any serious concerns. Staff spoken with were aware of even subtle forms of abuse such as not using a preferred name when addressing someone, or not giving people choice. They knew where to get guidance and relevant phone numbers at the home for reporting of suspected abuse, saying they would report any suspicions to senior staff, or to agencies outside the home if necessary. Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 12 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): These core standards were met at the last inspection. EVIDENCE: Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 13 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): 28 There are adequate levels of staff employed, with an appropriate variety of skills and training to meet residents’ needs safely. EVIDENCE: There were three care assistants, a care support staff, and Christopher Arnold on duty when the inspector arrived, looking after 25 residents. Mr & Mrs Arnold were at the home from mid-morning, and there was also a cook, two domestic staff and a handyman at the home. Residents and staff commented on the recent increase in the ‘business’ of the home, with some more able residents feeling they were receiving less attention because there were more residents needing more help. But other residents said staff were always available. And residents looked well cared for. Two hours of extra staffing had already been organised for mornings, in recognition of this recent increase in care to be given. Staff felt staffing levels were generally adequate; although they appeared to be continually occupied during the inspection, they were calm and polite as they attended to their duties. Over half of the care staff have a Care NVQ2 or higher. All senior carers have a Care NVQ3. Two senior staff have NVQ4 in management, and a third is undertaking it. Staff spoken with were knowledgeable about residents’ needs, and had good opportunities for training in a range of topics – two had attended training on dementia care, and two attended training on activities, for example. Certain senior carers have undertaken appropriate manual handling training and health and safety training that equips them to train other staff. Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 14 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, 35 & 38 The Home benefits from the skills and experience of the Registered Manager. The Home’s practices safeguard residents’ financial interests. Health and safety matters are well monitored and managed, minimising possible risks to residents and staff. EVIDENCE: Mrs Arnold has been the home’s manager for 11 years, is a registered nurse, and has NVQ4 in management. Residents and staff felt the home was well managed, with concerns, complaints and suggestions listened to. The home appeared orderly yet homely on this unannounced inspection. Mrs Arnold confirmed the home does not currently keep any personal monies for residents, nor are staff appointees for any residents. Lockable storage is provided on request, for safekeeping of valuables, money, etc. Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 15 Staff spoken with and the fire log evidenced that fire safety checks and fire drills were carried out regularly; fire extinguishers checked had been serviced recently. Upper windows, where inspected, had restrictors fitted. A current Employers’ Liability insurance certificate was displayed. Accident forms seen had appropriate levels of detail. Staff felt it was a safe environment, with any repairs needed carried out quickly. They had had recent updating in relevant topics – manual handling, fire safety, etc. Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Tudor Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? 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 Lodge DS0000015974.V276772.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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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