Inspection on 12/12/05 for Tudor Lodge

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 31/07/08

Tudor Lodge 19/09/06

Tudor Lodge 14/06/05

Tudor Lodge 01/02/05

Tudor Lodge 15/06/04

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Tudor Lodge Tudor Lodge 18-20 Manor Road Folkestone Kent CT20 2SA Lead Inspector Julian Graham Unannounced Inspection 12th December 2005 10:15 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 DS0000059434.V267545.R01.S.doc Version 5.0 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 DS0000059434.V267545.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tudor Lodge Address Tudor Lodge 18-20 Manor Road Folkestone Kent CT20 2SA 01303 251195 01303 251195 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) Mr Kanagaratnam Rajamenon Mr Kanagaratnam Rajaseelan Mrs Julie Williams Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user with (MD) to be restricted to one (1) whose DOB is 14/10/1944. 15th June 2004 Date of last inspection Brief Description of the Service: Tudor Lodge is a residential care home providing care and support for up to forty-four older people. The home has been owned by 1st Choice Care Homes for the past year. The manager of the home is Mrs Julie Williams. Her application for registration with CSCI is currently being processed. The home is situated near to Leas Cliff and is convenient for the town centre of Folkestone. There is a small front garden, a rear garden and parking facilities. Accommodation is provided on four floors and there is a lift and stair lifts connecting each floor. There are three lounges and a large dining room that is one two level. The home has forty-one bedrooms, thirty-five of which have ensuite facilities. It is within level walking distance of the bus and railway stations Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10.15 and lasted approximately five and a half hours. Eleven of the residents were spoken with, some in the privacy of their own rooms. Two carers were interviewed individually in the office, and staff were observed directly and indirectly as they were going about their work. Whilst examination of paperwork was not a primary focus of this inspection, time was spent with the manager and some documentation was viewed. A brief tour of the premises was undertaken. Residents said they are being well cared for, and in the main made very positive comments about the home. These included: “very nice, very comfortable, very friendly”; “couldn’t have better care from your own family”; “they look after me very well”; “staff are there when you want them, and are not there when you don’t!” A First Aid training course was in progress at the time of the visit, and the trainer said there was a lovely feel to the home, and that staff were interacting very well together. Two residents said that they were not as happy in the home as they used to be. One resident has recently been assessed as needing care beyond which the home is able to provide as identified by its category of registration. The home is aware that it will need to apply for a variation to its registration should there be a protracted delay in finding alternative accommodation for this person. What the service does well: Residents receive good care from a staff team who are well trained and supported in their work. Residents spoke of flexible routines, with staff showing them respect and kindness. Many of the staff have worked in the home for a long time now, and the settled and stable team benefits the residents by providing consistency and continuity of care. An Activities Co-ordinator works two afternoons a week, and range of interesting and fun activities are available for those residents wanting to join in. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 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. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 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 DS0000059434.V267545.R01.S.doc Version 5.0 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): Not inspected on this visit. EVIDENCE: Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 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): 7,10 The care planning system adequately provides staff with the information they need to meet residents’ needs, although some are in need of review. Some risks relating to residents are not being effectively identified and assessed, potentially placing residents at risk of harm. Personal care is offered in a way that protects residents’ privacy and dignity. EVIDENCE: A small sample of care plans was viewed. These contain a lot of information relevant to the care of the residents. Some are need of reviewing, however, with one last reviewed as long ago as May. Whereas some activities undertaken by residents that involve risk have been identified and assessed, some have not. For example, whilst it is commendable that a small number of residents are continuing to access the community independently, the home must ensure that this activity is risk assessed and that periodic checking is done within a risk management framework, to make sure that residents continue to be safe going out on their own. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 10 Staff were seen interacting with residents respectfully, with patience and good humour. Residents spoken with, who need support and assistance from staff regarding their personal care needs, said they feel staff treat them with respect and uphold their rights to privacy. Medication was not examined in full on this occasion. However, it was noted that a requirement made at the last inspection regarding revising parts of the medication policy has mainly been adequately met. The policy on disposal of medication needs some amendment still, and it is recommended that a lockable fridge is provided to store medicines requiring cold storage. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 11 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 are given opportunities to participate in social and recreational activities. Residents are helped to exercise choice and lead the lives they want. Meals are generally appealing. EVIDENCE: Most of the residents spoken with said that they have enough things to do to enable them to have an interesting day. The activities co-ordinator comes to the home on two afternoons each week and offers a variety of activities, including reading stories to the residents, singing, board games and so on. The inspector took part in a game of skittles with some of the residents during the visit. One or two residents said that there was little to do to keep occupied and that it’s a “bit boring.” Staff maintain that a number of things offered in the way of leisure and entertainment, including trips out, are declined by the residents. The home is very handily placed for accessing the local community, and residents are from time to time supported by staff in going into the town for shopping, going to the bank and so forth. Staff who were interviewed were very clear as to their role in offering choices to residents, and gave some examples in support of this. Residents can choose, for example, where to have their meals. Some prefer to eat in their rooms, others to come down to the dining room. Lunch was shared with the Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 12 residents, and this was a tasty and well-presented meal, with two choices, which residents said they enjoyed. Comments from residents regarding meals prepared during weekdays were positive. Some residents are however complaining about some meals cooked at weekends, and the manager is currently talking with the cook as to how things can be improved. The last meal of the day is either at 4.30 for those eating in their rooms, or 5.00 for those choosing to eat in the dining room. It is recommended that residents be consulted about the timing of this meal to check whether it suits them. Staff said that a snack is available later in the evening for residents who say they would like one. For those residents who may not like to ask, it is recommended that staff specifically ask them whether they would like something else to eat, rather than wait to be asked. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 13 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 Residents are confident that their complaints will be listened to and acted upon. Staff have good knowledge and understanding of adult protection issues which protects residents from abuse. EVIDENCE: Residents spoken with said that they would feel confident in making a complaint and that action would be taken to address their concerns. Copies of the complaints procedure were seen in residents’ bedrooms. One complaint had been recorded since the last inspection, and this appeared to be appropriately handled. The manager was in the process of recording complaints made by two residents (see previous section of this report regarding meals) as the inspector was arriving for the visit. (See also the Management and Administration section of this report.) Both staff who were interviewed knew the action to take in the event of any allegation or suspicion of abuse. Most staff have received training on adult protection issues. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 14 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): 19,20,21,25,26 The standard of the environment is mainly good. Some areas are needing attention. EVIDENCE: The dining room and three bedrooms have been refurbished since the last inspection, also some areas within the basement of the home. Décor is generally satisfactory, providing the residents with a comfortable place to live. Some areas, particularly the wall at the top of the stairs leading to the second floor, which is badly stained as a result of a leak in a bathroom, need attention. Wallpaper is also peeling on the landing outside rooms 36 and 37. The manager said that the handyman is about to redecorate these areas. The home was at a comfortable temperature and all areas seen were clean. It is recommended that the chair with a fabric covered seat in the bathroom on the second floor is replaced with a plastic one, for ease of cleaning and to minimise the risk of cross infection. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 15 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 Residents are being supported and cared for by competent and committed staff in sufficient numbers to meet residents’ needs. EVIDENCE: Rotas were viewed and showed that there are normally four or five carers on duty in the mornings, and three carers in the afternoons and evenings. The manager is supernumerary to these numbers. Many of the residents are currently requiring minimal support from staff in respect of their personal care needs, so staffing levels appear adequate at this time. There has been little in the way of staff turnover, and many of the staff have been working in the home for a number of years. Staff have therefore got to know the residents very well, and this consistency of care is of benefit to them. Training was not looked at in detail on this occasion, although the training matrix showed that staff are accessing training, with most staff having undertaken courses on health and safety, fire safety and adult protection within the past twelve months. A new in-house training package to augment the externally run courses has been purchased. Seven staff have a NVQ. The manager acknowledged that she is behind on the individual staff one to one supervision programme. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 16 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): 31,32,33,37,38 Residents are benefiting from the ethos and management approach of the home. Not all records are being kept securely which compromises residents’ rights. Safe working practices are generally being promoted, although systems for identifying potential environmental hazards need improving to more effectively safeguard residents. EVIDENCE: The manager is gaining in management experience and is not far away from completing the Registered Manager’s Award. She is aware of some aspects of the administrative functioning of the home needing attention, including a closer monitoring of care plans and risk assessments. Staff who were interviewed referred to the good support they receive from the manager who was described as approachable and helpful. There was a friendly and welcoming atmosphere in the home. Some confidential records were seen unsecured in the entrance hall. It is a requirement of this report that all Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 17 individual records and home records are kept secure at all times. The manager seeks the views of the residents in a variety of ways, including informal discussion on a daily basis, and periodic Residents’ Meetings. Residents have recently been given the opportunity to fill in a satisfaction questionnaire about the care and service provided, and the manager is in the process of collating the results. Environmental risk assessments need reviewing to ensure all hazards are identified, any significant risks assessed, and controls put in place to minimise risk. This includes the use of freestanding radiators, one of which was noted in a bedroom. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 18 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 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x x 2 2 2 Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 19 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. 1 2 3 4 Standard OP7 OP19 OP37 OP38 Regulation 15 23 17 13 Requirement Timescale for action 12/01/06 Care plans to be reviewed by care staff once a month. A programme of redecoration to 12/02/06 be produced, with a timetable for planned implementation. All confidential records to be 12/12/05 kept securely. Risk assessments relating to 01/01/06 residents and the environment to be reviewed and updated and suitable controls put in place to minimise risk. 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 4 Refer to Standard OP9 OP15 OP15 OP15 Good Practice Recommendations Provide a lockable fridge for medication needing cold storage. Review quality of weekend meals as planned. Consult with residents regarding their preferred time for their evening meal. Staff to ask residents if they would like any snack/drink DS0000059434.V267545.R01.S.doc Version 5.0 Page 20 Tudor Lodge 5 OP26 during the evening. Replace chair in second floor bathroom. Tudor Lodge DS0000059434.V267545.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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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