Inspection on 14/06/05 for Tudor Lodge

This inspection was carried out on 14th June 2005.

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 31/07/08

Tudor Lodge 19/09/06

Tudor Lodge 12/12/05

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 18-20 Manor Road Folkestone Kent CT20 2SA Lead Inspector Wendy Mills Announced 14 June 2005 9:30 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 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 H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tudor Lodge Address 18-20 Manor Road, Folkestone, Kent, CT20 2SA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 251195 10303 251195 Mr Kanagaratnam Rajamenon Mrs Carol Ann Gillett-Jones Care Home only 44 Category(ies) of Older People x 44 registration, with number of places Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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 currrently being processed. The home is situated near to Leas Cliff and is convienent 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 H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection began at 9.30 am and lasted seven hours. During the course of the inspection, the inspector spoke to fifteen residents and had in depth conversations with six of them in private. Four members of staff spoke to the inspector in private and discussions took place between the manager and the registered providers. In addition, the inspector was able to obtain the views of a visiting health care professional on the day of inspection. Key documentation, including a twenty percent sample of care plans, was examined, and a tour of the home was undertaken. Responses to preinspection questionnaires that were sent to the residents, their relatives and supporters and to the home have also been taken into account in this report. The residents were found to be very well cared for and they, and their relatives, spoke highly of the care that the staff give. Staffing levels are good and the workforce is stable. Some residents and staff said that they would like to see more of the home owners and spend time talking to them. What the service does well: The home cares for the residents very well. It provides a comfortable, welldecorated, clean and homely environment and is very supportive to the needs of both the residents and their relatives. It provides a range of activities and employs an activities organiser in order to help residents become involved in activities if they wish. The home maintains very good relationships with local General Practitioners and other Healthcare Professionals. It works well in partnership with them to ensure that the health and well being of the residents is promoted. It states, and adheres to, sound principles and core values such as promoting independence, choice, privacy, dignity and respect. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4 &5 The home’s Statement of Purpose and Service User Guide are very good. They provide residents and prospective residents with the information they need to make a decision about moving into the home. The assessment and admissions procedures for the home are sound. They ensure that only residents whose needs can be met will be admitted to the home. EVIDENCE: Both the Statement of Purpose and the Service User Guide have been reviewed and updated since the last inspection. The Service User Guide has been completely re-written in plain English. It contains some excellent illustrations and is now much more accessible to the residents. Inspection of a twenty percent sample of care plans and discussion with some residents confirmed that there are written terms and conditions that are understood by the residents. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 9 Inspection of the care plans of the most recently admitted residents showed that all appropriate admissions procedures had been followed. The home’s policies and procedures are clear about encouraging pre-admission visits and trial periods. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10&11 There is a clear and consistent care planning system that the residents understand. The home works diligently to meet the health, personal and social care needs of the residents. The home manages the receipt, disposal, storage and administration very well. However, new polices and procedures no lack clarity and fail to give staff adequate guidance in respect of the administration of medicines. This places the residents at risk of harm. The home deals with end of life issues very well indeed. EVIDENCE: Inspection of care plans and tracking to other relevant documentation and discussion with the manager, staff and residents showed that there is a clear care planning process. All care plans are kept up-to-date. They are regularly reviewed. The residents said that they can talk to the manager and staff and that they know they will respond to their needs. Residents said that they know written records are kept about them and that they trust the manager to keep these records securely and to maintain confidentiality. Some said that Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 11 although they know this and can be involved in the care planning process if they wish, they prefer not to become involved. A visiting health care professional said that “Tudor lodge is one of the better home I visit”. She said that the home always co-operates with her in the care of the residents and is very good at carrying out any specific instructions. Responses to the relatives’ questionnaire included comments such as, “My mother has been extremely well cared for by all the staff and they continue to look after her with exceptional care,” and, “I have always found the staff very welcoming and helpful.” Observation of staff who administered medicines showed that they are clear and diligent about the correct procedures. However, the area manger has recently introduced new policies and procedures for the management of medicines in the home and these are difficult to understand, confusing and lack clear directions for correct procedures. This must be changed as a matter of urgency as they are unhelpful to staff and put the residents at risk of harm. The staff are, however, commended for their good practice in handling medicines and for maintaining a good level of training in this area. Work is in progress to provide a clinical room for the storage of medicines. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 &15 The home meets the social, cultural, religious and recreational needs for the residents very well. It helps them maintain links with both the local community and their families. The home offers choice and respects individuality. The meals are nutritious. The home caters for special diets and there is a choice of menu. EVIDENCE: The home employs an activities co-ordinator and a written record of activities is kept. Activities take place daily and residents are offered the chance to participate. Some residents participate in a variety of activities, such as board game, craft, music and singing. Others said that they preferred to spend more time in their rooms, reading, listening to music or watching television and some said they preferred to go out independently. Some residents said they would like the chance to go on more outings. The home has arranged a barbeque at a sister home in the very near future. Links are maintained with the local community. Local church groups provide church services in the home for those who wish to attend. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 13 There is a varied menu and a choice of two main meals each day. In addition, salads, sandwiches and snacks can be provided if preferred. The inspector took lunch on the day of inspection and found it to be both appetising and nutritious. There is an adequate budget for the food.b Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 standard(s) 16,&18 The residents and their supporters know that concerns will be listened to and acted upon. The staff have a good knowledge of Adult Protection issues. This protects the residents form abuse EVIDENCE: Residents said that the manager visits them frequently deals quickly with any concerns they may have. They also said that they can talk to the staff and that they are always willing to help them. Some residents said that they had no complaints, only praise for the manager and her staff. There have been no formal complaints since the last inspection. Relatives said that any minor problem is usually solved quickly and to their satisfaction. There is a clear complaints policy and procedure that has been made even more accessible in the new Service User Guide. The staff to whom the inspector spoke were all clear about the adult protection procedures and the whistle-blowing policies. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25&26 The standard of the environment of the home is good. Planned redecoration and refurbishment of the communual areas will ensure that this is further improved. EVIDENCE: A tour of the home showed that bedrooms are well maintained and that the standard in décor in most areas is good. Six more bedrooms have been refurbished and the number of bedrooms with en-suite facilities has now increased to thirty-five. Most bedrooms are very large and allow for both a siting and bedroom area. This gives the rooms a very comfortable and homely feel. There are plenty of bathing and toilet facilities including specially adapted baths In some of the communual areas, whilst the décor is still reasonable, the décor is now looking a little tired and scuffed. The registered providers said that they have just finished the process of obtaining estimates for a re-decoration Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 16 and refurbishment programme of these areas and expect work to begin within the next two months. The home was very clean, homely and free from all offensive odours on the day of inspection. No health and safety hazards were noted during the tour of the home. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Staffing levels are sufficient to meet the needs of the residents and the staff have formed positive relationships with the residents. This ensures that the residents receive a good and consistent standard of care. Recruitment procedures are sound and there is a high level of on-going staff training. Communication with staff could be improved in some areas. EVIDENCE: Staffing rosters show that adequate numbers of staff are scheduled for each shift. Generally staff felt that they are able to meet the needs of the residents. the home rarely has to use agency staff but the manager said that she is able to use agency if the need arises. There is a low staff turnover and staff are clearly committed to maintaining a high standard of good care practice. Examination of staff files showed that all appropriate checks have been made prior to employment of staff in the home. Staff perceive that the communication from the area manager and the registered providers could be better. For example, currently there is a programme of refurbishment going on in the home. Staff welcome this but would like to know when work is likely to take place, and where, as they believe this influences the lives of the residents. Staff would like the opportunity of becoming more involved so they can ensure that the lives of the Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 18 residents are disrupted as little as possible. More frequent, structured staff meetings at which both the area manager and the registered providers attend may help foster improved communication. The registered providers should provide a written two year development plan to both the manager and the CSCI. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32.33. The manager is well supported by her senior care staff in providing clear leadership throughout the home. All staff demonstrate a good awareness of their roles and responsibilities. The residents benefit from a well run home but quality assurance systems could be improved by better communication with staff and residents in order to seek their views. EVIDENCE: Staff said that they respect the manager and that she understands their needs. She promotes a good level of training in the home and takes into account their views and those of the residents. The manager confirmed that she feels well supported by both the area manager and the registered providers as identified under the group of standards for staffing. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 20 The manager is making good progress with the NVQ IV in Management and care. Her application for registration with the CSCI is currently being processed. The registered providers are frequently in the home to oversee maintenance and works programmes. They join in social occasions with residents when possible. They have made significant financial investment in the home over the past year and said that the home remains financially viable. However, they believe that the low fees paid by social services could threaten the home’s financial position in the future. There is good and regular communication between the manager and the care staff. However, some staff said they would like to meet more frequently with the area manager and the registered providers on a more formal basis. This would improve and formalise quality assurance systems. Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 x 3 2 2 2 x 3 3 3 3 Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 22 no 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. Standard 9 Regulation 13(2) Requirement The policies for receipt, storage, administration and disposal of medicines must be revised to provide clear procedures. Timescale for action 30/08/05 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. Refer to Standard 32 Good Practice Recommendations There should be more formal meetings and/or consultaions between registered providers, the area manager and the residents and care staff in order to inform them of developments planned for home and to seek their views on running of home. f Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Tudor Lodge H56-H05 S59434 Tudor Lodge V225395 140605 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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