Inspection on 03/11/05 for Tudor Rose Rest Home

This inspection was carried out on 3rd November 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 Rose Rest Home 30/11/09

Tudor Rose Rest Home 01/12/08

Tudor Rose Rest Home 19/12/07

Tudor Rose Rest Home 23/05/07

Tudor Rose Rest Home 26/10/06

Tudor Rose Rest Home 20/06/06

Tudor Rose Rest Home 09/08/05

Tudor Rose Rest Home 07/12/04

Tudor Rose Rest Home 13/07/04

Tudor Rose Rest Home 24/02/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Tudor Rose Rest Home 671 Chester Road Erdington Birmingham West Midlands B23 5TH Lead Inspector Kath Strong Unannounced Inspection 3rd November 2005 13:35 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 Rose Rest Home DS0000059825.V264671.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 Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tudor Rose Rest Home Address 671 Chester Road Erdington Birmingham West Midlands B23 5TH 0121 384 8922 0121 241 3507 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) Careplex Jackie Barrett Care Home 27 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (5), Old age, of places not falling within any other category (27) Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Employ a recognised care management consultancy service for the first 12 months following change of registration That one named person who is under 65 years at the time of admission can be accommodated and cared for in this home That the home can care for one named service user in need of care for reasons of dementia. (1 DE(E)) That the home can care for up to five service users in need of care for reasons of mental health problems (5 MD(E)). 9th August 2005 Date of last inspection Brief Description of the Service: Tudor Rose is registered to provide residential care for up to 27 persons for reason of old age with a maximum of five who may suffer from mental health illness. The property is a converted and extended domestic residence. The premises are situated on a busy main road close to local shops and amenities. It is very conveniently situated for bus and rail services to Sutton Coldfield and Birmingham city centre. The home’s frontage blends well with the adjacent residential properties. There is sufficient off road parking at the front of the building to accommodate three vehicles, further parking is available in nearby side roads. The majority of the accommodation is located on the ground and first floors; a shared room is situated on the second floor that has its own adjacent bathroom. There is a shaft lift to all floors that permits a maximum of two persons. This restriction in conjunction with the narrow corridors prohibits the home from caring for wheelchair users. Communal toilets and bathrooms are strategically located throughout the home. Bedrooms are a mixture of single and shared rooms; all include wash hand basins and a call system. The communal rooms are situated on the ground floor and consist of two lounges and two dining rooms. There is an extensive rear garden with out houses and a paved area including seating that residents and visitors can frequent during clement weather. Meals and a laundry service are supplied on site. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the visit was to conduct an unannounced inspection and to review the progress made in respect of the two requirements generated from the last inspection. The outcome was determined by various means. In depth discussions were held with the registered manager, a brief discussion with the deputy manager and five residents were spoken with individually. Relevant documentation was reviewed including two care plans and a partial tour of the premises carried out. At the conclusion verbal and written feedback was provided to the registered manager. This inspection was restricted to the few key standards not examined at the previous inspection and others deemed necessary. To gain a complete overview of the standard of the services provided this report should be read in conjunction with the report from the inspection carried out 9th August 2005. What the service does well: The home adopts a proactive approach to requirements generated as a result of inspections and maintains a positive professional relationship with CSCI. The registered manager is well supported by the deputy manager and the responsible individual. The deputy manager has specific management responsibilities. The registered manager is supernumery, she provides personal care if required and assists with tasks such as deep cleaning within the home. Comments received from residents were positive regarding accommodation, meals and the services provided by staff. The involvement of external professionals is actively sought and advice is acted upon. The home has a maintenance programme for repairs and re-decoration, which is regularly updated. Tudor Rose Rest Home DS0000059825.V264671.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 Rose Rest Home DS0000059825.V264671.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 Rose Rest Home DS0000059825.V264671.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): None EVIDENCE: Standards 1, 2, 3, 4, and 5 were examined at the last inspection and were fully met. Tudor Rose Rest Home DS0000059825.V264671.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, 8 and 10 Residents care needs are well documented and there is good evidence of the input of external professionals in supporting staff in meeting the identified needs. EVIDENCE: Care plans indicated that physical and mental health needs were being identified and provided instructions on how the needs should be met. The files contained details such as preferences regarding the way in which personal care should be delivered ranging from prompts to full assistance. Regular monitoring and recording of individual’s weights are carried out. Files also indicated activities of daily living and goals in respect of recreational activities. Daily records were maintained up to three times each day. The home has regular visits by a district nurse and other professionals visit or residents are supported in attending external appointments. During the visit an ophthalmologist was present and carrying out eye tests on the majority of the residents. A resident said, “ I definitely enjoy living here”. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 10 Observations revealed that staff interactions with residents were positive and personal care is provided in the privacy of a bathroom or the respective bedroom. Standards 9 and 11 were examined at the last inspection and were fully met. Tudor Rose Rest Home DS0000059825.V264671.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 and 15 Activities are provided on an ad hoc basis at the request of the current client group and residents are supported in maintaining links with the community. Meals provided constitute a wholesome, varied and balanced diet with residents choosing what they wish to eat. EVIDENCE: The home has a daily activities programme on display in the reception area. The registered manager advised that it is not being adhered to because residents have requested daily consultation and the current client group make limited requests and are also reluctant to go out. Indoor activities consist mainly of bingo, games and discussions. Some residents go out for walks, two occasionally go out shopping with relatives. One resident goes to church every Sunday. The home is currently planning the Christmas festivities; a party is to be arranged relatives will be invited to attend. Arrangements are in place for residents to have Christmas lunch in a hotel. One resident’s daughter whom she had not seen for 13 years had recently visited the home. The registered manager said that in order to maintain the contact she is planning a reciprocation visit by taking the resident to Weston Super Mare. The home is advised to regularly review the activities programme in order to ensure that resident’s preferences are being met. Standards 14 and 15 were examined at the last inspection and were fully met. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 12 The registered manager advised that the food menu had been recently reviewed, a greater range of evening snacks are available and the vegetables are being cooked and presented in a more interesting way. Residents continue to enjoy a roast meal every Sunday and again during the week. A resident said, “The food is very good”. Tudor Rose Rest Home DS0000059825.V264671.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): None EVIDENCE: Standards 16 and 18 were examined at the last inspection and were fully met. Tudor Rose Rest Home DS0000059825.V264671.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, 22, 24, 25 and 26 Residents reside in a comfortable, safe and well maintained home, which offers a choice of communal rooms. Bedrooms are personalised and promote privacy. Hygiene levels in respect of communal carpets was not acceptable. EVIDENCE: The home has a main lounge and a further smaller lounge; there are two adjoining dining rooms and a large rear garden which residents frequent during clement weather. The main lounge and dining rooms are utilised for in door recreational pursuits, which permits different activities to be held in conjunction with each other. The corridor space and capacity of the shaft lift prevents the home from accommodating wheelchair users. Fixtures and fittings are of a good standard and well maintained. The home has a maintenance programme that is regularly up dated. Residents spoken with expressed their satisfaction with the accommodation. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 15 Communal toilets are strategically located on each floor, staff access for those requiring assistance is limited. Residents are provided with a choice of bathing, assisted bathing facilities are available. All rooms have a call system, which is for the safety of residents also linked to fire escape exits. Raised toilet seats and handrails are installed and there is a mobile hoist within the building. Bedrooms vary in size and layout. There is a mixture of single and shared rooms; all have a wash hand basin. They are personalised and residents are encouraged to take in their personal possessions including items of furniture. Lockable facilities are available for those who request them and all rooms have suited door locks. The home was found to be warm, comfortable and well lit by domestic style lighting. The laundry and kitchen were clean and tidy and all relevant checks and cleaning was being carried out in the kitchen. The lounge carpets were found to be badly stained, the carpet in the main lounge was sticky under foot. An immediate requirement was left in respect of this. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 16 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): None EVIDENCE: Standards 27, 28, 29 and 30 were examined at the last inspection and were fully met. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 17 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): 35, 36 and 38 The process for the safeguarding of residents personal monies is robust. Regular formal staff supervisions are carried out demonstrating staff competence to carry out their role. Practices within the home serve to ensure the health and safety of staff and residents. EVIDENCE: Standards 31, 32 and 33 were examined at the last inspection and were fully met. The system deployed by the home for the safe keeping of resident’s personal monies was examined and found to be satisfactory. Regular staff supervisory meetings are being carried out, documented and signed by both parties. Although these are more detailed than previously it is Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 18 recommended that the records could be further improved as the space permitted for free text is somewhat restrictive. All aspects of health and safety measures were in place at the last inspection with the exception of an up to date risk assessment regarding fire safety. The document has been reviewed and re-written and found to be comprehensive. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 3 X 3 3 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 3 X 3 Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 20 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 OP26 Regulation 23(2)d Requirement The registered manager must ensure that all carpets are kept clean. Timescale for action 17/11/05 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. 2. Refer to Standard OP12 OP36 Good Practice Recommendations The registered manager is recommended to regularly review the residents wishes in respect of the lack of a formal activities programme. The registered manager is recommended to ensure that the tool utilised for staff supervisory meetings permits sufficient space for comprehensive free text. Tudor Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Rose Rest Home DS0000059825.V264671.R01.S.doc Version 5.0 Page 22 - 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. 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