Inspection on 03/12/08 for Tudor Lodge

This inspection was carried out on 3rd December 2008.

CSCI found this care home to be providing an Excellent service.

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 13/12/06

Tudor Lodge 01/03/06

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tudor Lodge 8 Brightstowe Road Burnham-on-Sea Somerset TA8 2HW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Poole     Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Tudor Lodge 8 Brightstowe Road Burnham-on-Sea Somerset TA8 2HW 01278784277 01278786844 mail@tudorlodge.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Judith Isabel Arnold Type of registration: Number of places registered: JDA Care Limited care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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. Fees at the home range from 390 to 515 pounds per week. 0 Over 65 27 Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out over one day. During this time the inspector was able to speak with people living and working at the home and to observe care practices. Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) setting out the homes achievements and their plans for the future. Care Homes for Older People Page 5 of 27 The inspector was given unrestricted access to all areas of the home and all records requested were made available. One visitor was spoken with during this inspection. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 7 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move into the home receive adequate information to assist them to decide if it is the right place for them. Everyone has their needs fully assessed before moving in and there are opportunities to spend time at the home before deciding to take up residence. Intermediate care is not provided. Evidence: Anyone wishing to move to Tudor Lodge has their needs fully assessed by the care manager at the home and outside professionals. This means that the home are confident that they are able to meet the needs and expectations of any new residents. Copies of pre admission assessments were seen in personal files. People spoken with during the inspection said that they, or their representative, had been able to spend Care Homes for Older People Page 10 of 27 Evidence: time at the home before deciding if it was the right place for them. One person who had recently moved to the home said that staff had assisted them to settle in by ensuring that they adequate information on a day to day basis. During the day it was observed that staff explained practises, such as the days and times of visiting healthcare and religious representatives to the new person. Everyone who moves to the home has a service user guide which gives clear information about the home including meal times and items included in the basic fee. An up to date copy of the service user guide and statement of purpose are displayed in the main entrance hall. The contract states that the first month of any stay is considered a trial period to enable everyone to be sure that Tudor Lodge is the right place for them. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have access to healthcare professionals according to their individual needs. Staff assist people in a sensitive manner and respect the privacy of people living at the home. Evidence: Everyone living at the home has a care plan that is personal to them. Three care plans were viewed in detail, all contained a full assessment of need and outlined peoples preferences. Individual needs are highlighted on the care plan and those seen showed evidence that care plans are up dated as needs and wishes change. People spoken to stated that staff were very attentive and that they received care that was based on their individual needs and promoted their independence where possible. It was noted that at the last staff meeting person centred care was discussed to ensure that all staff were aware of the need to provide care and support that was appropriate to each individual. Care Homes for Older People Page 12 of 27 Evidence: Daily records showed that peoples health needs are monitored and appropriate professionals are contacted as required. Assessments are carried out in respect of physical healthcare needs such as moving and handling and the promotion of skin care. There is evidence that people have access to healthcare professionals according to their individual needs. People were happy with the support that they received with personal care and one person commented that staff were sensitive when assisting with intimate care and respected their privacy. It was observed that staff spoke to people in a respectful manner and knocked on personal rooms before entering. The home uses a Monitored Dosage System (MDS) for medication. Staff who administer medication have received training from the dispensing pharmacist. Medication Administration Records were well maintained and correctly signed when arriving at the home and when administered or refused. This gives a clear audit trail. Some people living at the home self administer their medication and risk assessments have been carried out. Currently medication handed over to people to self administer is recorded in personal files. It is recommended that any medication handed over to people for self administration is clearly recorded on the Medication Administration Record. Controlled drugs were sampled and records kept correlated with stocks held. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home continue to make choices about their day to day lives. There is an extensive programme of activities including regular trips out. Visitors are always welcome in the home. Evidence: People living at the home stated that they are able to make decisions about what time they get up, when they go to bed and how they spend their day. People were happy that they continued to be able to decide what they did each day and remained in control of their day to day lives. There is a comprehensive programme of activities in the home which are advertised each week so that people can decide which activities and events that they would like to take part in. People said that there was no pressure to join in with activities and were able to take part in things that interested them. One member of staff takes overall responsibility for co ordinating activities. Care Homes for Older People Page 14 of 27 Evidence: There is an organised activity every day and people said that there was a wide variety of things going on. Each morning a member of staff leads an activity and in the afternoon activities are arranged using outside entertainers and facilitators. On the day of the inspection there was a bingo session in the morning, in the afternoon a gentle excercise class took place and a visiting vicar held communion. Other regular activities include quizzes, reminiscence, aromatherapy and musical entertainment. There are visiting clergy from different denominations to enable people to continue to practice there faith and some people attend churches outside the home. In response to requests from the people living at the home they have begun to organise more trips out. Many people spoken with during the inspection said that they had enjoyed going out to lunch earlier in the week. People said that they had enjoyed various outings during the year and were looking forward to Christmas shopping and going to the theatre. Everyone asked said that there was no set visiting times and that they were able to entertain visitors at any time. One person visiting the home during the inspection said that they, and their family were always made welcome. The main meal of the day is at midday and there are two sittings so that people have some choice about when they eat their lunch. People are able to eat their meals in the dining room or in the privacy of their private rooms. The weeks menu is displayed by the dining room and copies are given to individuals in their rooms. People asked were very happy with the food saying that their was a wide variety of meals and ample portions. Lunch was observed during the inspection. Food was well presented and appeared appetising. Vegetable dishes and condiments were placed on tables to enable people to make choices about what they ate and portion size. Discreet assistance was given when required. Trays were taken to people who wished to eat in their rooms and again these meals were very well presented and hot. People spoken with were very happy with the quality and selection of meals. Two people, who required special diets, made particular comments about the efforts of the cook to ensure that they received varied and appetising food. Hot and cold drinks are available throughout the day and there were bowls of fresh fruit in the lounge. It was observed that some people helped themselves to fruit and cold drinks and staff offered it others throughout the day. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home feel comfortable to raise concerns or complaints with staff and management. There are systems in place to minimise the risks of abuse to people who live at the home. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Since the last inspection the home has received 7 complaints. The complaints log was viewed and this gives details of the complaint made, the action taken to address and the level of satisfaction with the outcome. It was apparent that the home takes all complaints seriously and takes action to address any issues raised. People spoken with during the inspection said that they would be comfortable to speak to staff or management if they were unhappy about any aspect of their care. People were confident that any worries would be listened to and that action would be taken to address any concerns that they had. There are systems in place to ensure that risks of abuse to people living at the home Care Homes for Older People Page 16 of 27 Evidence: are minimised. All staff receive training of recognising and reporting abuse and those spoken with were aware of the ability to take serious concerns outside the home. It was noted that staff interacted with people living at the home in a kind respectful manner. People said that staff were always polite and helpful. The recruitment procedure has been made more robust since the last inspection and this now ensures that appropriate checks have been undertaken before people begin work in the home. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Tudor Lodge is maintained to an excellent standard and provides a comfortable warm environment for the people who live there. Standards of cleanliness throughout the home are excellent. Evidence: Tudor Lodge is located in a quiet residential area of Burnham on Sea. It is close to the town centre and sea front. There is an ongoing programme of maintenance and refurbishment that ensures all parts of the home are maintained to a very high standard. All areas of the home are fitted with a fire detection and call bell system. The building is an older style house which has been extended over the years to provide accommodation for up to 27 people. There are 23 single rooms and 2 which can be used as doubles if people wish to share. A sample of bedrooms was viewed. Bedrooms are comfortably furnished and well maintained. People are able to bring personal possessions, including small items of furniture, which gives rooms an individual and homely appearance. The majority of rooms (20) have en suite facilities. Care Homes for Older People Page 18 of 27 Evidence: All communal areas are located on the ground floor and are accessible to people with all levels of mobility. There is a large lounge, a conservatory and dining room. All rooms are well maintained and pleasantly furnished. Since the last inspection the lounge has been redecorated and rearranged. Outside the home there is a large well maintained garden which people living at the home have unrestricted access to. Aids and adaptations have been fitted throughout the home to ensure that people are able to maintain their independence where possible. There is a well organised laundry which is appropriate to the needs of the people who live at the home. To promote good infection control practices there are hand washing facilities throughout the home. There is a small team of domestic staff, who take an obvious pride in maintaining a very high standard of cleanliness within the home. The home has recently been awarded an excellent rating of 5 stars by the environmental health officer. Many people living at the home, and one visitor, commented that the home was always kept very clean and fresh. All areas seen during the inspection were warm, immaculately clean and well maintained. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by a staff team who are well motivated and have received relevant training. Recruitment practices minimise the risks of abuse to people who live at the home. Evidence: The home employs 14 care staff, 9 (64 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. The home also employs 11 ancillary staff. There is always a senior carer on duty who offers support and guidance to less experienced staff. Staff spoken with, and observed, were well motivated and enthusiastic about their jobs. All staff complete a comprehensive induction programme and there are good opportunities for ongoing training. Records viewed showed that in addition to statutory training in health and safety issues, staff have received training in the protection of vulnerable adults and issues of abuse, bereavement, diabetes, sensory deprivation awareness and the Mental Capacity Act. People spoken with felt that staffing levels were adequate and the management gave Care Homes for Older People Page 20 of 27 Evidence: assurances that they kept staffing levels under review to ensure that they were appropriate to the needs of people living at the home. People living at the home said that staff always appeared busy but they responded quickly if they rang their call bell for assistance. Everyone asked felt that staff were kind and polite. Comments included staff cant do enough for you, you can ask them anything nothing is too much trouble and staff here are lovely. The recruitment records of the four most employed members of staff were viewed. These gave evidence of a robust recruitment procedure which included obtaining references and carrying out checks against the Protection Of Vulnerable Adults (POVA) register before they began work. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is effectively managed taking account of the views of the people who live there and other interested parties. There is a clear management structure giving clear lines of accountability and responsibility. Evidence: The registered manager of the home is Judy Arnold. She has many years experience of working with older people and has achieved the Registered Managers Award (NVQ level 4). In addition to the registered manager there is also an operations manager and a care manager, both of whom hold the Registered Managers Award. The care manager and operations manager oversee the day to day running of the home and are very visible in the home. Everyone asked said that the management team were open and Care Homes for Older People Page 22 of 27 Evidence: approachable. It was observed that people appeared comfortable with all members of the management team. The management gives clear leadership and direction to the home. The management team is supported by senior carers, giving clear lines of accountability and responsibility. Prior to the inspection the registered manager completed an Annual Quality Assurance Assessment setting out the achievements of the home and their plans for the future. There is an obvious commitment to providing a high quality service and to ongoing improvement. This year the home has achieved the investors in people award. The home has an annual improvement programme in place which looks at the care delivered and the environment. Regular audits are also in place. There are regular meetings for people living and working at the home. Minutes of meetings demonstrated that suggestions made at residents meetings are discussed at staff meetings to ensure that people living at the home are able to influence practices within the home. The home survey people living at the home and other interested parties on a regular basis. Results of surveys are analysed and suggestions put into practice where possible. Returned questionnaires showed a high level of satisfaction. There is also a suggestion box where people can write suggestions at any time. All staff receive regular supervision which is another way to monitor the quality of care and an opportunity for people to air their views. The home does not act as a financial appointee or power of attorney for anyone living at the home and does not assist anyone with personal finance. Appropriate systems are in place to ensure health and safety in the home. A maintenance person is employed and all areas are maintained to a good standard. Fire alarms are regularly tested in house and the system is serviced by outside contractors. The lift in the home is serviced every three months and other lifting equipment is serviced annually. Gas and electrical installations and appliances are regularly tested. Staff receive regular training and up dates on health and safety issues. Clear records are kept in respect of all maintenance of the environment and servicing of equipment. All accidents in the home are recorded. Up to date certificates of insurance and registration are displayed in the entrance hall. Care Homes for Older People Page 23 of 27 Evidence: Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 It is recommended that medication passed to people to self administer is recorded on the Medication Administration Record. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!