Inspection on 19/09/06 for Tudor Lodge

This inspection was carried out on 19th September 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 31/07/08

Tudor Lodge 12/12/05

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 Wendy Mills Unannounced Inspection 19th September 2006 09:30 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.V299330.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 Lodge DS0000059434.V299330.R01.S.doc Version 5.2 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 Rajaseelan Mr Kanagaratnam Rajamenon 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.V299330.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user with (MD) to be restricted to one (1) whose DOB`s is 06/12/1920. 12th December 2005 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 is been owned by 1st Choice Care Homes. The registered manager of the home is Mrs Julie Williams. Approval for her registration with the CSCI was granted earlier this year. She holds the NVQ IV in Management and Care and the registered Manager’s Award. The home is situated near to Leas Cliff and is convenient for the town centre of Folkestone. There is a small front garden and a well-maintained and flat rear garden. There are parking facilities to the rear of the home. Accommodation is provided on four floors and there is a shaft lift and stair lifts that connect each floor. There are three lounges and a large dining room that is on two levels. 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. The fees for this home range between £303 and £395 Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced and lasted approximately six hours. Seven residents were spoken with in private and a further ten were spoken with during the course of the visit. Four carers were spoken to and staff were observed directly and indirectly as they were going about their work. Key documentation, such as staff files and care plans was examined. Telephone contact was made with both health and social care professionals who visit the home. Comments were received from some relatives. Time was spent in discussion with the registered manager and a tour of the home was undertaken. Residents said they are well cared for and were positive about their experience of living in the home although some, understandably, said they wished they could still be in their own homes but realised that this was not possible and said that the home is “the next best thing”. What the service does well: There is a relaxed and friendly atmosphere in the home. A good standard of care is provided and there is a clear awareness amongst the staff and the registered manager of the principles of best practice in care. Residents said that the staff treat them with respect and kindness and that they can choose how to spend their time. There is a stable and well-trained staff team. Many of the staff have worked in the home for a long time and say how much they enjoy working in the home. The high morale and stability of the staff team means that the residents receive consistent care from a cheerful and committed staff. The home provides a good range of activities. An Activities Co-ordinator works two afternoons a week, and range of interesting activities are available for those residents wanting to join in. Recently there has been an outing for a pub lunch, a cheese and wine party to which relatives and friends were invited and a pottery class. On the day of inspection there was a harvest festival service with Holy Communion in the morning and a sing along session, led by a visiting group of musicians in the afternoon. The home supports the residents to maintain as much independence as possible. It helps the residents to make informed decisions about their care and how they spend their time. The environment of the home is welcoming, clean and well maintained. Tudor Lodge DS0000059434.V299330.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. Tudor Lodge DS0000059434.V299330.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 Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. Appropriate pre-admission assessments are made to ensure that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: The home has a statement of purpose and a service user guide that meet the required standards. The complaints policy and procedure has recently been reviewed. The service user guide is available in large print and is also now on audiotape. There are sound pre-admission policies and procedures in place. Inspection confirmed that good pre-admission assessments had been made and recorded Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 9 for all recently admitted residents. Discussion with the registered manager confirmed that a suitably qualified person always carries out pre-admission assessments. Care managers confirmed that the home works closely with them in respect of admissions. The home communicates well with the CSCI in respect of admissions and has a good history of ensuring that only those people whose needs can be met are admitted. The registered manager is commended for the diligence she shows in respect of potential admissions to the home. Whilst not all residents were able to remember if they had been given copies of the service user guide, due to short term memory problems, many residents said they had a copy and were clear about their rights whilst living in the home. No residents are admitted for intermediate care but some are admitted for respite care, for example, when adaptations are needed to their homes or whilst care packages are set up. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The home provides good care for the residents. There are sound policies and systems for the administration of medicines. Personal care is offered in a way that protects residents’ privacy and dignity. The home deals with end of life issues very well indeed. EVIDENCE: A sample of care plans was viewed. These included three care plans for the most recently admitted residents. The care plans contain good information that is relevant to the care of the residents. However, some care plans were not clearly signed and dated. This means that it was difficult to ascertain whether there had been significant change over a period of time. In some care plans statements such as, “all personal care,” had been made but there was no description as to how personal care should be carried out. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 11 Staff were noted to interact well with residents. They treated them respectfully and with patience and good humour. Residents said that the staff help them maintain their dignity when giving personal care and support. There are sound policies and procedures for the management and administration of medicines within the home. Key staff have received medication training and there is a page in each care plan that lists the current medication of each service user. There are clear policies for dealing with terminal illness and death. The home has a good history of supporting residents at the end of their lives. The wishes of the residents and/or their relatives in respect of hospital admission are recorded. The home looks after the residents for as long as they can meet their needs. They give very good support relatives during times of severe illness and death of a resident. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The independence of the residents is promoted. They are supported to make informed choices and lead the lives they want. EVIDENCE: An activities co-ordinator comes to the home on two afternoons each week and offers a variety of activities. On the day of inspection there was a harvest festival service with Holy Communion in the morning and a sing along session led by a group of musicians in the afternoon. Staff had accompanied one new resident on a walk to take a look at the surrounding area. Other activities include a recent pottery class and outing for a pub lunch. There has also been a very successful cheese and wine party to which friends and relatives were invited. A further cheese and wine party is planned for later this year. One or two residents said that there was little to do to keep occupied but said that they don’t like a lot of the activities on offer. Other residents said they were glad that they weren’t expected to join in, as they preferred to remain in their rooms and read or watch television. One relative Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 13 said that it would be nice if the residents could have more “one-to-one” time with staff. It is clear that the residents feel the staff respect their choices about activities. The home is very close to the town centre and some residents are able to go out on their own. One resident has a mobility scooter and this is stored safely and well maintained by the home. Nearly all the residents spoken to said that they were able to choose what they do, where they take their meals and how they manage their finances. However two residents said that they felt the night staff treated them like “naughty children” when they stayed up late, reminding them that it was “eleven o’clock”, with the unspoken suggestion that it was “time for bed”. The home must ensure all staff understand and respect the rights of the residents to live their lives in the way they choose. Prior to the inspection a set of sample menus was supplied to the CSCI. These appear appetising and nutritious. Since the last inspection, when there had been some adverse comments about the meals at weekends, a new cook has been appointed for the weekends. The residents said that now there is no difference in the quality of meals at weekends when compared to weekdays. Residents said that they enjoyed their meals and that they have plenty to eat. One resident who takes meals in their rooms said that sometimes it’s difficult to concentrate on eating. It was noted that food from both courses had been left to go cold. The home should closely monitor the food intake of all residents but especially those who may have short-term memory loss and choose take their meals alone. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The home manages complaints appropriately and in a timely way. There is a good awareness of Adult protection procedures. This protects the residents from harm. EVIDENCE: The residents said that they knew they could talk to any of the staff or the manager if they have any concerns or complaints. There has been one formal complaint since the last inspection. This was investigated immediately and a full explanation given There are sound policies and procedures for managing complaints and for the protection of vulnerable adults (POVA). Staff have received POVA training and say they would always report another member of staff if they had any concerns. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The environment of the home is good. This provides the residents with a pleasant, safe and homely place in which to live. EVIDENCE: A tour of the home was made. All areas were clean, tidy and free from offensive odours. There is a continuous improvement plan for the home and a maintenance person is employed. Since the last inspection the main lounge has been decorated and new carpet and furniture provided. The windows on the lower ground floor have been refurbished and the corridors in this area have been painted. There are plans to redecorate another lounge soon. Since the last inspection the reception desk has been moved. This has improved the security of records and confidentiality. It has also made the area more welcoming for visitors. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 16 The residents said that they like the spacious feel of their rooms. They have been able to bring items from home to make their rooms more homely. The rooms reflect the personalities, families and interests of the residents. The communal areas are spacious but homely. Outside there is a safe flat and well-maintained garden. There has been a recent asbestos check carried out on the home and an Occupational Therapy assessment of the home was scheduled for the week following this visit. No health and safety hazards were noted during the tour of the home. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. There is a stable staff team. Staffing levels, staff training and morale are all good. This means that the residents receive consistent care from a cheerful and competent staff team. Recruitment policies, procedures and practice are sound. This means that the home does not employ unsuitable staff. EVIDENCE: A sample of staff files was examined. This included the files for the most recently appointed staff. There was good evidence to show that induction training had taken place for all new staff. Staff who have worked at the home longer have all received appropriate training. Two more members of staff are about to begin the NVQ level II course and one is about to start on level III. The home has purchased an in-service training package. Staff are now working through this with the guidance of the manager and the area manager. There is a very low turnover of staff but when new staff have been appointed pre-employment checks were seen to have been carried out properly and a record made. Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 & 38 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The home is well managed and run in the best interests of the residents. EVIDENCE: Since the last inspection the manager has been approved for registration with the CSCI. She has also gained the NVQ IV in Management and Care and the Registered Manager’s Award. She maintains a personal portfolio and this was inspected. There is good evidence that she maintains her professional development and is committed to continuous learning. Staff respect her leadership qualities and the residents say that they can always talk to her if they have any concerns. The manager holds a budget for the day-to-day running of the home. This means that she can directly order food from local shops, organise ongoing Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 19 repairs and checks without having to wait for approval from the area manager. This saves time and ensures that repairs are carried out immediately. The area manager visits the home regularly and submits reports to the CSCI in accordance with Regulation 26. She has established one-to-one supervision for the manager and this is now being cascaded to the team leaders. The home should try to establish one-one–one supervision for all staff as soon as possible. There are clear policies and procedures for safeguarding the residents’ monies. Discussion with the manager showed that she is constantly reviewing the situation and would be prepared to refer any untoward financial matters to the Adult Protection Team Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 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 3 3 3 3 3 2 3 3 Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP36 Regulation 18 Requirement One-to-one supervision to be established for all staff Timescale for action 31/12/06 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 OP7 Good Practice Recommendations Home should involve the residents more in the review of their care plans. The home should also ensure that the care plans contain enough detail for staff to care for the residents. The home should monitor the intake of food of residents who choose to eat in their own rooms more closely. 2. OP15 Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI Tudor Lodge DS0000059434.V299330.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!