Care Home: Tudor Care Home

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What the care home does well The home provides detailed information about the accommodation and facilities available. Care plans are carefully produced with the new resident, family and supporters. There are opportunities to follow individuals leisure pursuits and participate in a range of activities- cooking, arts and crafts and assisted trips out. The environment is very well maintained, clean, tidy and homely. Attention is given to meeting people`s individual and dietary needs, with home cooked, nutritious meals provided. A relative told us, "Meals look absolutely fine. When I visit they offer me a hot drink and biscuits served on a tray, and I am made welcome." What has improved since the last inspection? This is the Care Quality Commission`s (CQC) first visit to this new service. What the care home could do better: The Staff Recruitment policy should be reviewed and updated. With attention to undertake all the necessary checks before new staff start working with residents. This will ensure residents are safe in the home. The fire risk assessment should be reviewed and updated and any actions taken. This will ensure residents are kept safe around fire prevention. Key inspection report Care homes for older people Name: Address: Tudor Care Home 68 Tudor Road Hinckley Leicestershire LE10 0EQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Helen Abel     Date: 1 6 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Tudor Care Home 68 Tudor Road Hinckley Leicestershire LE10 0EQ 01455234968 02476272162 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cofresh Homes LLP Name of registered manager (if applicable) Ms Lucinda Nicholls Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 8 The registered person may provide the following categories of service only: Care Home only - Code PC; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category-code OP, Dementia-code DE, Physical Disability Code PD Date of last inspection Brief description of the care home Tudor Care Home is a small residential care home in Hinckley. The home has 8 beds and is registered to cater for older people, people both male and female who are over the age of 65 years old or have dementia or a physical disability. They provide 24 hour Care Homes for Older People Page 4 of 24 Over 65 0 8 0 8 0 8 2 0 0 7 2 0 0 9 Brief description of the care home care and accommodation on permanent or temporary respite basis. The home is based in a 1920s two storey bulding in a residentail area of Hinckley in Leicestershire. The current fees range from £404-800 per week. Care Homes for Older People Page 5 of 24 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: two star good 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: This was an unannounced visit on Wednesday 16th June 2010 at 9.15 am. The focus of the inspections is on outcomes for service users and their views of the service provided. The primary method of Inspection used was case tracking which involves selecting a sample number of service users and tracking the care they received through looking at their records and talking with them where possible. The Inspector was unable to communicate with one service user and needed a staff member to assit her. In addition the Inspector spoke with relatives and supporters of the residents, care staff, and the Registered Provider and Registered Manager. A plan was made prior to the visit in which available information from the registration report, annual quality assurance assessment, and service history were examined. The people living at Tudor Care Home prefer to be called residents. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 24 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 24 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. New residents are involved in the needs assessment process and are provided with written information before they enter the home. Evidence: Written information is available to prospective and current residents. A Statement of Purpose provides written information about:- the resident group, style of accommodation, support, treatment philosophies and specialist services available. A relative told the Inspector they had visited and looked around the home before deciding to use the service. They confirmed the service was very personable and their relative is well cared for. Another resident specifically asked to come to the home and family members made the arrangements with the Registered Manager. All new residents receive a comprehensive needs assessment before admission with Care Homes for Older People Page 10 of 24 Evidence: the Registered Manager Cindy Nicholls. Individuals are supported and encouraged to be involved in the assessment process. Family members told us they had contributed to the assessment process. Assessments from other care management agencies were also obtained. All the information was gathered together to provide an individual plan of care that meets the needs of the person using the service. Care Homes for Older People Page 11 of 24 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. Staff pay attention to meeting the health and care needs of residents, which help residents to feel well looked after. Evidence: The care plans are developed with the person using the service. They are person centred and focused on the individuals strengths and personal preferences. Care plans contain risk assessments with risks identified and managed positively, to help residents lead the life they want. A resident confirmed, they are well looked after and staff are kind and caring. Attention is paid to ensuring residents are treated with respect and dignity. The Registered Manager provides guidance to the new staff group on best practise and how staff should support peoples dignity. Staff try to help residents to be as independent as they are able to. The record keeping in relation to medication is good. The Registered Manager and staff team have received accredited medicine training, and reported good working Care Homes for Older People Page 12 of 24 Evidence: relations with the community pharmacist. Care Homes for Older People Page 13 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are enabled to have a good lifestyle in the home. Evidence: Residents are able to make choices in their daily lifes. Some people prefered to spend time sitting in the communal areas. One resident told us about baking a cake with staff in the kitchen, doing arts and crafts, and taking trips out to the local shops. A summer trip to the seaside is being planned with residents. The Registered Manager confirmed the staff are planing some set-menus and they are looking closely at healthy eating options. The Inspector observed residents were offered a choice at lunch time and had different meals. Meals served were seen to be freshly cooked, healthy and nutritious. A relative told us, Meals look absolutely fine. When I visit they offer me a hot drink and biscuits served on a tray, and I am made welcome. Care Homes for Older People Page 14 of 24 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. Residents are protected regarding staff awareness regarding complaints and safeguarding from harm. Evidence: The homes complaints policy is provided in the written information in the Statement of Purpose. Copies of this are displayed round the home. Contact details on how to contact an Advocate are also displayed around the home. One resident confirmed feeling safe at Tudor Care Home. All staff have had safeguarding adults training. Safeguarding Adults guidance for staff to follow was updated following on out visit to ensure staff have access to the most current guidance available. This will ensure residents are protected from harm. Care Homes for Older People Page 15 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a comfortable and clean living environment. Evidence: During our visit, we looked around parts of the home. A sample of bedrooms, bathrooms and toilets were checked. We found all areas to be clean, fresh and tidy. Residents are able to have their own possessions in their bedrooms. Bedrooms looked comfortable and were personalised with family photographs and peoples own items . The lounge and dinning area were homely, light and bright and comfortable with scatter cushions, bowls of fruit and magazines. The lounge overlooked the back garden. A shaded area had been temporarily erected outside and residents regularly use this. There is a ramp to the garden area. This will ensure the garden area is accessible to all the residents. A visitor confirmed bring in pots of flowers to go into the garden. The Registered Manager confirmed the garden will be re-developed soon in consultation with the residents group. The Registered Provider told us he makes make sure, together with the Registered Manager that safety precautions and checks are carried out in the home. The Inspector noted one fire door was left open. Managers immediately agreed to action Care Homes for Older People Page 16 of 24 Evidence: this. The home should review their fire risk assessment. This would ensure residents safety. Relatives told us, Once inside, the home is lovely. The Inspector discussed the front of the home with the Registered Provider, he agreed improvements will be made. Care Homes for Older People Page 17 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well trained staff team Evidence: The Inspector checked a sample, of staff records. One staff member did not have a second written reference. It is recommended the staff recruitment policy and procedure is reviewed. This will give residents confidence, that staff are safe to work with them. The home has provided a wide range of training before staff starting working directly with residents, and continues to provide ongoing training. Examples of staff training are dementia care, first aid and infection control and National Vocational Qualification in Care (NVQ). Staff team meetings and staff supervisions are starting to commence. Residents are supported by trained competent staff. Care Homes for Older People Page 18 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well managed home. Evidence: The Registered Manager Cindy Nicholls run this new home in a positive and open way. Staff feel they can approach the manager and be well supported. Attention is paid to making sure that the quality of service provided is the home is good. The Registered Provider Mr Joshi carries out quality checks assurance checks of different aspects of the service, including spot checks and prepares reports on a regular basis. Together the Registered Provider and Registered Manager work closely making sure the home is run properly, keeping residents safe. Staff have training in safe aspects, such as food hygiene, moving and handling and fire safety. There are procedures in place, which tell staff how to work safely. Care Homes for Older People Page 19 of 24 Evidence: A fire door was identified by the Inspector to be kept closed. The Registered Provider agreed action would be taken to the identified room to ensure all fire safety requirements are met. A review of the fire risk assessment to be undertaken. (See Requirement made under Environment section). This will ensure all residents are protected from harm. Care Homes for Older People Page 20 of 24 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 21 of 24 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 1 19 23 The Registered person shall after consultation with fire authority- (c) Make adequate arrangements (v) For reviewing fire precautions, and testing fire equipment, at suitable intervals. To ensure residents safety the homes fire risk assessment should be reviewed and updated to include any changes. This will ensure residents are adequately protected against the risk of fire. 30/06/2010 2 29 19 Information and Documents 30/06/2010 in Respect of Persons Caring on, Managing or Working the Care Home. 5. Two written references relating to the person. To ensure staff are safe to work with residents correct Care Homes for Older People Page 22 of 24 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 recruitment checks must take place before staff commence work in the home. 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 29 Residents must be assured that staff have the correct recruitment checks in place before they start working in the home. The staff Recruitment Policy should be reviewed and updated. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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