Care Home: Tudor Court LA

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What the care home does well Service users benefit from an experienced and stable staff team. They are provided with a good amount of individual care and attention and supported to maintain control over their lives, and the decisions they make are respected. The manager and staff team are committed to providing a high standard of care in the home. The home has an experienced and enthusiastic team of staff who work well together and enjoy taking part in training and development sessions. The staff are motivated and keen to ensure that residents receive high standards of care. Six staff returned our surveys and comments included were: "The manager gives good training" Tudor Court looks after the residents well and provide excellent individual care for each service user". The physical accommodation is of a good standard, with appropriate aids and adaptations available for the residents. The manager is experienced and runs the home well. She makes sure she checks out staff before they start working at the home and gives them training and support to make sure they did the job to the best of their ability. The manager communicates a clear sense of direction and is able to evidence a sound understanding and application of `best practice`, What has improved since the last inspection? The premises have been completely refurbished during the time the care home was closed. The physical accommodation is now of a good standard, with appropriate aids and adaptations available for the people who use the service. What the care home could do better: In their AQAA the manager recognised that they have improvements to make in several areas and have provided us with details on how they want to improve the home. We discussed with the manager the areas of improvement we found to be required and these included the review of all the care plan documents to ensure that there is one complete set of paperwork operating in the home that will ensure the care of the service users is recorded in a way that sets out the goals and how these are to be achieved. The documentation was fragmented and different staff held separate notes relating to the needs of the service user. A complete set of notes recording the goals and the progress of the individual in relation to their care would benefit both the staff and the service user. The care plans were not being kept up to date so that the care staff would have the information they needed to meet the health and personal care needs of the residents. There is little written evidence that service users or their representatives are actively involved in the planning and review of the care. A record of minor concerns should be maintained by the manager to demonstrate howthese matters are being addressed Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tudor Court LA Tudor Court Seymour Street Heywood Rochdale Lancs OL10 3AJ     The quality rating for this care home is:   two star good 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: Bernard Tracey     Date: 2 7 0 2 2 0 0 9 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. 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. 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 © (2009) 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 Court LA Seymour Street Tudor Court Heywood Rochdale Lancs OL10 3AJ 01706364427 01706628700 ss.tudorcourt@rochdale.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rochdale M.B.C. Name of registered manager (if applicable) Miss Heidi Tombling Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category 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 (maximum number of places: 19). Physical disability : Code PD (maximum number of places: 1). The maximum number of service users who can be accommodated is 19. Date of last inspection Brief description of the care home Tudor Court was temporarily closed on 16 July 2007, in order that a total refurbishment could take place. The permanent people living there at that time were, following consultation, transferred to Meadow View, another Local Authority home, until Tudor Court was re-opened in April 2008. Care Homes for Older People Page 4 of 27 0 1 Over 65 19 0 care home 19 Brief description of the care home The home is a purpose built residential home owned by Rochdale Council offering accommodation for 19 service users, including 10 intermediate care five assessment beds with 2 long term care beds. The Intermediate Care Unit offers a short-term programme of rehabilitation for up to six weeks for older people leaving hospital or for those in the community who may otherwise need admission to a hospital bed. All rooms are single and suitable for wheelchair users as they all measure in excess of 12 square metres. There are no en-suite facilities. The home is situated approximately half a mile from the centre of Heywood where there is a wide variety of shops, pubs, cafes, etc. Ramped access for wheelchair users is provided to the front and rear of the home. There are safe garden areas, which residents enjoy during the summer months. Adequate parking is available to the front of the building. There are no charges made for Intermediate Care. Weekly fees varied dependent upon the service and the individual finances of the service user. No charge was made for intermediate care. Additional charges were made for private chiropody, hairdressing, papers/magazines, transport for outings, holidays and clothes. The provider made information about the service available upon request in the form of a Service User Guide and Statement of Purpose, which were given to new residents. At the last inspection, a copy of the most recent Commission for Social Care (CSCI) inspection report was displayed in the entrance hall together wi Care Homes for Older People Page 5 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: 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: Tudor Court has been closed during the period of July 2007 and April 2008 to allow for a complete refurbishment of the premises. This is the first key Inspection undertaken since the premises were re-opened. The last inspection took place on the 28th November 2006. We (the Commission of Social Care Inspection) undertook a key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. The manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do Care Homes for Older People Page 6 of 27 better and what they have improved upon. Where appropriate, these comments have been included in the report. Comment cards were received from six members of staff. We spent seven hours at the home over two days. During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. We spent time speaking to three residents, as well as speaking to four staff, the manager and the Team leaders. We have not received any complaints about the service since our last Inspection. What the care home does well: What has improved since the last inspection? What they could do better: In their AQAA the manager recognised that they have improvements to make in several areas and have provided us with details on how they want to improve the home. We discussed with the manager the areas of improvement we found to be required and these included the review of all the care plan documents to ensure that there is one complete set of paperwork operating in the home that will ensure the care of the service users is recorded in a way that sets out the goals and how these are to be achieved. The documentation was fragmented and different staff held separate notes relating to the needs of the service user. A complete set of notes recording the goals and the progress of the individual in relation to their care would benefit both the staff and the service user. The care plans were not being kept up to date so that the care staff would have the information they needed to meet the health and personal care needs of the residents. There is little written evidence that service users or their representatives are actively involved in the planning and review of the care. A record of minor concerns should be maintained by the manager to demonstrate how Care Homes for Older People Page 8 of 27 these matters are being addressed 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. 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 9 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 10 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. Service users are provided with clear information regarding the admission and assessment procedures to ensure they are informed how their care needs are to be met Evidence: The home provides Intermediate Care facilities for up to eleven male and female residents who require a period of short - term support and rehabilitation to enable the individual to return home and live independently or with the appropriate support services in place. There are also five assessment places and two permanent service users living at the home. For services users who require Intermediate Care, it is usual that the residents needs are assessed in hospital before admission to the home to ensure the placement in a rehabilitation unit is appropriate to their needs. Care Homes for Older People Page 11 of 27 Evidence: Residents are provided with clear information regarding the admission and assessment procedures to ensure they are informed how their care needs are to be met. The home is adequately equipped to enable skills assessments to take place, including Occupational Therapy kitchen assessments and a Physiotherapy service to assess and treat mobility. Care Homes for Older People Page 12 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. Care plans do not always fully demonstrate how aspects of health, personal and social care needs would be met. Evidence: We examined 4 care plans during our visit to the service. The manager had informed us in the completed self assessment sent before the visit (AQAA), that care plan documentation was under review, but at the time of our visit the new documentation had not been introduced. A selection of care plans plans looked at for those service users requiring Intermediate Care, those requiring assessment and a permanent resident. The detail contained in the care plans varied, as did the consistency of records maintained in them. Of the 4 care plans we examined in detail, two care plans gave clear instructions and guidance on how the care needs of the residents were to be met. They were reviewed regularly and any changes were noted and acted upon. Care Homes for Older People Page 13 of 27 Evidence: However one care plan indicated that a resident had not been reviewed and recording of his weight had not been regularly maintained. One individual had not been assessed for mobility, moving and handling and a care plan to inform the staff how risk of falls is minimised had not been devised. There was no evidence of relatives and the resident being involved in the drawing up and review of care plans were seen, though we were informed in the AQAA that relatives and residents are offered the opportunity to review care plans on a formal basis in order to ensure their agreement with the plan of care and where appropriate make amendments to the care plan. The people who use the service benefit from twice weekly visits from the homes GP who also visits on request Residents also have regular access to visiting optician, chiropodist and dentist. Service users spoken with told us that they were completely satisfied with the care they received at the home and were were full of praise for the professional and exceptional care provided. The medications system was safe. Medications were securely stored; the prescription administration sheets were filled in accurately and there was an accurate record of medicines received into the home and arrangements have been made for the disposal of unused medicines. Appropriately trained staff administered medication to residents. As part of the assessment process, prospective residents are assessed as to their ability to manage their own medication, currently those residents who do so receive appropriate support and monitoring by the care staff to enable this to continue. People who use the service told us that their wishes and preferences in regard to personal hygiene and continence care are documented within the care plan and are actively promoted through staff deployment where practicable to maximise respect and dignity for clients and all residents are addressed by their preferred form of address. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are encouraged to retain as much personal freedom as possible, to make their own choices and keep control over their lives. Evidence: An activity timetable was displayed in the dining area During morning there was a group armchair activity taking place. Leisure and recreational activities are not provided as a dedicated part of the service due to the content of the therapy provision and the rehabilitation process. Future social needs are discussed, concentrating on appropriate support and exploring possible day care links on the service users return to home. Service users are encouraged to maintain contact with their family and friends as well as accessing facilities in the local community. Service users are able to receive visitors and meet with them in private. Without exception residents received appropriate and sensitive assistance with their meals. The lunchtime meal was taken in a relaxed environment, soft music playing in the background, with staff and residents regularly interacting with each other. Time Care Homes for Older People Page 15 of 27 Evidence: was taken for residents to eat their meals and staff would ask each person if had they finished or would like a further helping.Staff were observed to assist those residents requiring help in a caring, sensitive and unhurried way, gently encouraging the resident to continue with their meal until they had finished eating. Menus were nutritious and balanced and included a good variety of meat, fish, fresh vegetables and fruit. The care staff confirmed that, should a resident request something that was not on the menu, alternative meals were available. Service users said they were asked in the morning what they would like from the choices for lunch and tea and all felt this was a good idea. There were many compliments and expressed satisfaction by residents and relatives in respect of the food offered by the home. Service users have two hot meal options at lunch and a hot or cold option at teatime and residents who have soft diets now receive the same menu as those on normal diets to increase variety. Tables are set with cups,saucers,cutlery and condiments for all meals and trays are provided for those who wish to eat in their rooms. Care Homes for Older People Page 16 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. The home has a clear complaints procedure and people who use the service know action will be taken to resolve their concerns. Staff have a good knowledge and understanding of Adult Protection issues which safeguards residents from abuse. Evidence: The home had a clear complaints procedure, which told people how and who to make any complaint to. The procedure was well advertised to relatives, and visitors to the home. Records showed that any complaints made had been fully investigated and responded to appropriately. Minor concerns should be recorded to aid the manager in assessing any ongoing problems and identifying trends within the home to assist the quality audits that are undertaken. A staff member said,If a client or their family wanted to make a complaint, I would go to the manager and give her the information. There was also evidence that where relevant, the manager made complaints on behalf of residents who received a poor service outside of the home. There is information available in the reception area of the home to provide people with the Advocacy services available in the area. No complaints have been made directly to the Commission for Social Care Inspection. All of the staff have undertaken training in relation to the Protection of Vulnerable Adults. The home also has an abuse policy and whistle blowing procedure. Care Homes for Older People Page 17 of 27 Evidence: The home has a copy of the Rochdale Guide for the Protection of Vulnerable Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a comfortable, homely and safe environment. Evidence: Tudor Court closed for a refurbishment in July 2007 and re-opened in April 2008 The home is purpose built and accommodation service users is provided on the ground floor. It is fully accessible to people who are physically disabled and is fitted with aids and adaptations to promote independence. The main entrance hall is spacious and there is ample information available regarding the home and the service it provides. The home is well maintained, decorated to a good standard and was clean and tidy during the site visit. There is a garden to the rear and car parking space to the front and the home has a central patio area with easy access on all sides of the home. A partial tour of the building was undertaken, two bathrooms, a shower room and six bedrooms were viewed. The bathrooms were clean and tidy and hot water temperatures are recorded each month to ensure the hot water is delivered to a safe temperature. Bedrooms viewed had individual items and were homely. A resident said, I have everything I need, including some of my own furniture. Bedrooms have door locks and storage space for valuable items. Bedrooms have a call system with a hand held buzzer to call for assistance. Care Homes for Older People Page 19 of 27 Evidence: The home is equipped with comfortable furniture, fittings and electrical equipment. There is a well equipped laundry and there was evidence of gloves and aprons for staff use. Infection control training is given to staff, although updating this training is now due, and infection control policies are available. Fire risk assessments of the building are in place and emergency lighting is provided throughout. Care Homes for Older People Page 20 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. The people who use the service were cared for by sufficient numbers of staff that were suitably qualified and trained, and therefore had the knowledge and skills to meet their needs. Evidence: The staff group has the skills and management support it needs to ensure that residents receive good care. Residents spoken to were very happy with the amount of staff on duty and said they are always helpful and available to see to anything you need doing and nothing is too much bother, all the staff are excellent. Records were available to indicate that staff received training from the start of employment with induction training to ongoing training and NVQ. The induction training was in line with Skills for Care requirements. Staff were positive about working in the home; they said that they enjoyed working there, that they delivered a good quality service and they said they received a good standard of training. Care Homes for Older People Page 21 of 27 Evidence: The staffing rotas were available and indicated that staffing levels were maintained at appropriate levels to meet peoples care needs. The staff team were well established and the turnover of staff was low. Care Homes for Older People Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a well- run home where their safety and welfare are promoted and protected. Evidence: The manager has the required qualifications and experience, and is competent to run the home, and is registered as the manager with the Commission for Social Care Inspection. She works to improve services and provide an increased quality of life for the people who use the service. There is a strong emphasis of being open and transparent in all areas of running of the home. The manager is supported by a competent staff team, and the home generally has a low staff turnover rate. Care staff reported that they received good support from the manager and have regular supervision to discuss their role and personal development. Health and safety issues were satisfactory with regular maintenance checks of Care Homes for Older People Page 23 of 27 Evidence: equipment being undertaken. All essential equipment had been appropriately maintained with records kept. Periodic inspections of gas, electricity and service of the hoists were examined and were current. 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 7 Wherever possible the individual or their representative should be involved in the review of the care plan so that their views are central to the care received. Each service user must have a care plan in place that accurately reflects their present needs So that the care staff will be able to give them the right care and assistance to aid their rehabilitations A record of minor complaints should be maintained to help the manager assess ongoing shortfalls in the service and detail what action has been taken to resolve the problems. 2 7 3 16 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. 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